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Georgeson P, Steinfelder RS, Harrison TA, Pope BJ, Zaidi SH, Qu C, Lin Y, Joo JE, Mahmood K, Clendenning M, Walker R, Aglago EK, Berndt SI, Brenner H, Campbell PT, Cao Y, Chan AT, Chang-Claude J, Dimou N, Doheny KF, Drew DA, Figueiredo JC, French AJ, Gallinger S, Giannakis M, Giles GG, Goode EL, Gruber SB, Gsur A, Gunter MJ, Harlid S, Hoffmeister M, Hsu L, Huang WY, Huyghe JR, Manson JE, Moreno V, Murphy N, Nassir R, Newton CC, Nowak JA, Obón-Santacana M, Ogino S, Pai RK, Papadimitrou N, Potter JD, Schoen RE, Song M, Sun W, Toland AE, Trinh QM, Tsilidis K, Ugai T, Um CY, Macrae FA, Rosty C, Hudson TJ, Winship IM, Phipps AI, Jenkins MA, Peters U, Buchanan DD. Genotoxic colibactin mutational signature in colorectal cancer is associated with clinicopathological features, specific genomic alterations and better survival. medRxiv 2024:2023.03.10.23287127. [PMID: 37090539 PMCID: PMC10120801 DOI: 10.1101/2023.03.10.23287127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Background and Aims The microbiome has long been suspected of a role in colorectal cancer (CRC) tumorigenesis. The mutational signature SBS88 mechanistically links CRC development with the strain of Escherichia coli harboring the pks island that produces the genotoxin colibactin, but the genomic, pathological and survival characteristics associated with SBS88-positive tumors are unknown. Methods SBS88-positive CRCs were identified from targeted sequencing data from 5,292 CRCs from 17 studies and tested for their association with clinico-pathological features, oncogenic pathways, genomic characteristics and survival. Results In total, 7.5% (398/5,292) of the CRCs were SBS88-positive, of which 98.7% (392/398) were microsatellite stable/microsatellite instability low (MSS/MSI-L), compared with 80% (3916/4894) of SBS88 negative tumors (p=1.5x10-28). Analysis of MSS/MSI-L CRCs demonstrated that SBS88 positive CRCs were associated with the distal colon (OR=1.84, 95% CI=1.40-2.42, p=1x10-5) and rectum (OR=1.90, 95% CI=1.44-2.51, p=6x10-6) tumor sites compared with the proximal colon. The top seven recurrent somatic mutations associated with SBS88-positive CRCs demonstrated mutational contexts associated with colibactin-induced DNA damage, the strongest of which was the APC:c.835-8A>G mutation (OR=65.5, 95%CI=39.0-110.0, p=3x10-80). Large copy number alterations (CNAs) including CNA loss on 14q and gains on 13q, 16q and 20p were significantly enriched in SBS88-positive CRCs. SBS88-positive CRCs were associated with better CRC-specific survival (p=0.007; hazard ratio of 0.69, 95% CI=0.52-0.90) when stratified by age, sex, study, and by stage. Conclusion SBS88-positivity, a biomarker of colibactin-induced DNA damage, can identify a novel subtype of CRC characterized by recurrent somatic mutations, copy number alterations and better survival. These findings provide new insights for treatment and prevention strategies for this subtype of CRC.
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Affiliation(s)
- Peter Georgeson
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
| | - Robert S. Steinfelder
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Tabitha A. Harrison
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Bernard J. Pope
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
- Melbourne Bioinformatics, The University of Melbourne, Carlton, Australia
| | - Syed H. Zaidi
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Conghui Qu
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Yi Lin
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jihoon E. Joo
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
| | - Khalid Mahmood
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
- Melbourne Bioinformatics, The University of Melbourne, Carlton, Australia
| | - Mark Clendenning
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
| | - Romy Walker
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
| | - Elom K Aglago
- Department of Epidemiology and Biostatistics, Imperial College London, School of Public Health, London, UK
| | - Sonja I. Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center(DKFZ), Heidelberg, Germany
| | - Peter T. Campbell
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andrew T. Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Medical Centre Hamburg-Eppendorf, University Cancer Centre Hamburg (UCCH), Hamburg, Germany
| | - Niki Dimou
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Kimberly F. Doheny
- Center for Inherited Disease Research (CIDR), Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David A. Drew
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jane C. Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Amy J. French
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Steven Gallinger
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Marios Giannakis
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Graham G. Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Ellen L Goode
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Stephen B Gruber
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte CA, USA
| | - Andrea Gsur
- Center for Cancer Research, Medical University Vienna, Vienna, Austria
| | - Marc J. Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Li Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeroen R Huyghe
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - JoAnn E. Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Victor Moreno
- Unit of Biomarkers and Suceptibility (UBS), Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L’Hospitalet del Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- ONCOBEL Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Faculty of Medicine and health Sciences and Universitat de Barcelona Institute of Complex Systems (UBICS), University of Barcelona (UB), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Neil Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Rami Nassir
- Department of Pathology, College of Medicine, Umm Al-Qura University, Saudi Arabia
| | | | - Jonathan A. Nowak
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mireia Obón-Santacana
- Unit of Biomarkers and Suceptibility (UBS), Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L’Hospitalet del Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- ONCOBEL Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Shuji Ogino
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Cancer Immunology Program, Dana-Farber Harvard Cancer Center, Boston, Massachusetts, USA
| | - Rish K. Pai
- Department of Pathology and Laboratory Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Nikos Papadimitrou
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - John D. Potter
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Robert E. Schoen
- Departments of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mingyang Song
- Departments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Wei Sun
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Amanda E. Toland
- Departments of Cancer Biology and Genetics and Internal Medicine, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Quang M. Trinh
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, Imperial College London, School of Public Health, London, UK
| | - Tomotaka Ugai
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Caroline Y Um
- Department of Population Science, American Cancer Society, Atlanta, Georgia, USA
| | - Finlay A. Macrae
- Parkville Familial Cancer Centre, and Dept of Colorectal Medicine and Genetics The Royal Melbourne Hospital
- Colorectal Medicine and Genetics, Royal Melbourne Hospital, Parkville, Australia
- Genomic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia
| | - Christophe Rosty
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
- Envoi Specialist Pathologists, Brisbane, Australia
- University of Queensland, Brisbane, Australia
| | | | - Ingrid M. Winship
- Genomic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia
- Department of Medicine, The University of Melbourne, Parkville, Australia
| | - Amanda I. Phipps
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Mark A. Jenkins
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Daniel D. Buchanan
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria 3010 Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, Victoria 3010 Australia
- Genomic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia
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Katsoulis M, Lai AG, Kipourou DK, Gomes M, Banerjee A, Denaxas S, Lumbers RT, Tsilidis K, Kostara M, Belot A, Dale C, Sofat R, Leyrat C, Hemingway H, Diaz-Ordaz K. On the estimation of the effect of weight change on a health outcome using observational data, by utilising the target trial emulation framework. Int J Obes (Lond) 2023; 47:1309-1317. [PMID: 37884665 PMCID: PMC10663146 DOI: 10.1038/s41366-023-01396-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 09/17/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND/OBJECTIVES When studying the effect of weight change between two time points on a health outcome using observational data, two main problems arise initially (i) 'when is time zero?' and (ii) 'which confounders should we account for?' From the baseline date or the 1st follow-up (when the weight change can be measured)? Different methods have been previously used in the literature that carry different sources of bias and hence produce different results. METHODS We utilised the target trial emulation framework and considered weight change as a hypothetical intervention. First, we used a simplified example from a hypothetical randomised trial where no modelling is required. Then we simulated data from an observational study where modelling is needed. We demonstrate the problems of each of these methods and suggest a strategy. INTERVENTIONS weight loss/gain vs maintenance. RESULTS The recommended method defines time-zero at enrolment, but adjustment for confounders (or exclusion of individuals based on levels of confounders) should be performed both at enrolment and the 1st follow-up. CONCLUSIONS The implementation of our suggested method [adjusting for (or excluding based on) confounders measured both at baseline and the 1st follow-up] can help researchers attenuate bias by avoiding some common pitfalls. Other methods that have been widely used in the past to estimate the effect of weight change on a health outcome are more biased. However, two issues remain (i) the exposure is not well-defined as there are different ways of changing weight (however we tried to reduce this problem by excluding individuals who develop a chronic disease); and (ii) immortal time bias, which may be small if the time to first follow up is short.
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Affiliation(s)
- M Katsoulis
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK.
| | - A G Lai
- Institute of Health Informatics, University College London, London, UK
| | - D K Kipourou
- Inequalities in Cancer Outcomes Network, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- AstraZeneca, London, UK
| | - M Gomes
- Department of Applied Health Research, University College London, London, UK
| | - A Banerjee
- Institute of Health Informatics, University College London, London, UK
- University College London Hospitals NHS Trust, London, UK
- Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - S Denaxas
- Institute of Health Informatics, University College London, London, UK
- Alan Turing Institute, London, UK
| | - R T Lumbers
- Institute of Health Informatics, University College London, London, UK
| | - K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maria Kostara
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece
| | - A Belot
- Inequalities in Cancer Outcomes Network, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - C Dale
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - R Sofat
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - C Leyrat
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - H Hemingway
- Institute of Health Informatics, University College London, London, UK
| | - K Diaz-Ordaz
- Dept of Statistical Science, Faculty of Maths & Physical Sciences, University College London, London, UK
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Rapti I, Asimakopoulos A, Liontos A, Kosmidou M, Christaki E, Biros D, Milionis O, Tsourlos S, Ntotsikas E, Ntzani E, Evangelou E, Gartzonika K, Georgiou I, Tzoulaki I, Tsilidis K, Milionis H. Association of patient characteristics with clinical outcomes in a cohort of hospitalised patients with SARS-CoV-2 infection in a Greek referral centre for COVID-19 - Corrigendum. Epidemiol Infect 2023; 151:e91. [PMID: 37288502 DOI: 10.1017/s0950268823000857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Affiliation(s)
- I Rapti
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - A Asimakopoulos
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - A Liontos
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - M Kosmidou
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - E Christaki
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - D Biros
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - O Milionis
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - S Tsourlos
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
| | - E Ntotsikas
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - E Ntzani
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA
| | - E Evangelou
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - K Gartzonika
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina45110, Greece
| | - I Georgiou
- Genetics and IVF Unit, Department of Obstetrics and Gynaecology, Medical School, University of Ioannina, Ioannina45110, Greece
| | - I Tzoulaki
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - K Tsilidis
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - H Milionis
- Department of Internal Medicine, Ioannina University Hospital, University of Ioannina, Ioannina, Greece
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Mahamat‐Saleh Y, Rinaldi S, Kaaks R, Biessy C, Gonzalez‐Gil EM, Murphy N, Le Cornet C, Huerta JM, Sieri S, Tjønneland A, Mellemkjær L, Guevara M, Overvad K, Perez‐Cornago A, Tin Tin S, Padroni L, Simeon V, Masala G, May A, Monninkhof E, Christakoudi S, Heath AK, Tsilidis K, Agudo A, Schulze MB, Rothwell J, Cadeau C, Severi S, Weiderpass E, Gunter MJ, Dossus L. Metabolically defined body size and body shape phenotypes and risk of postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition. Cancer Med 2023; 12:12668-12682. [PMID: 37096432 PMCID: PMC10278526 DOI: 10.1002/cam4.5896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/06/2023] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Excess body fatness and hyperinsulinemia are both associated with an increased risk of postmenopausal breast cancer. However, whether women with high body fatness but normal insulin levels or those with normal body fatness and high levels of insulin are at elevated risk of breast cancer is not known. We investigated the associations of metabolically defined body size and shape phenotypes with the risk of postmenopausal breast cancer in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition. METHODS Concentrations of C-peptide-a marker for insulin secretion-were measured at inclusion prior to cancer diagnosis in serum from 610 incident postmenopausal breast cancer cases and 1130 matched controls. C-peptide concentrations among the control participants were used to define metabolically healthy (MH; in first tertile) and metabolically unhealthy (MU; >1st tertile) status. We created four metabolic health/body size phenotype categories by combining the metabolic health definitions with normal weight (NW; BMI < 25 kg/m2 , or WC < 80 cm, or WHR < 0.8) and overweight or obese (OW/OB; BMI ≥ 25 kg/m2 , or WC ≥ 80 cm, or WHR ≥ 0.8) status for each of the three anthropometric measures separately: (1) MHNW, (2) MHOW/OB, (3) MUNW, and (4) MUOW/OB. Conditional logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Women classified as MUOW/OB were at higher risk of postmenopausal breast cancer compared to MHNW women considering BMI (OR = 1.58, 95% CI = 1.14-2.19) and WC (OR = 1.51, 95% CI = 1.09-2.08) cut points and there was also a suggestive increased risk for the WHR (OR = 1.29, 95% CI = 0.94-1.77) definition. Conversely, women with the MHOW/OB and MUNW were not at statistically significant elevated risk of postmenopausal breast cancer risk compared to MHNW women. CONCLUSION These findings suggest that being overweight or obese and metabolically unhealthy raises risk of postmenopausal breast cancer while overweight or obese women with normal insulin levels are not at higher risk. Additional research should consider the combined utility of anthropometric measures with metabolic parameters in predicting breast cancer risk.
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Affiliation(s)
| | - S. Rinaldi
- International Agency for Research on CancerLyonFrance
| | - R. Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DFKZ)HeidelbergGermany
| | - C. Biessy
- International Agency for Research on CancerLyonFrance
| | | | - N. Murphy
- International Agency for Research on CancerLyonFrance
| | - C. Le Cornet
- Division of Cancer EpidemiologyGerman Cancer Research Center (DFKZ)HeidelbergGermany
| | - J. M. Huerta
- Department of EpidemiologyMurcia Regional Health CouncilMurciaSpain
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - S. Sieri
- Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei Tumori20133MilanItaly
| | - A. Tjønneland
- Danish Cancer Society Research CenterCopenhagenDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - L. Mellemkjær
- Danish Cancer Society Research CenterCopenhagenDenmark
| | - M. Guevara
- Navarra Public Health Institute31003PamplonaSpain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)28029MadridSpain
- Navarra Institute for Health Research (IdiSNA)31008PamplonaSpain
| | - K. Overvad
- Department of Public Health, Section for EpidemiologyAarhus UniversityAarhusDenmark
| | - A. Perez‐Cornago
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - S. Tin Tin
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - L. Padroni
- Department of Clinical and Biological SciencesUniversity of TurinTurinItaly
| | - V. Simeon
- Dipartimento di Salute Mentale e Fisica e Medicina PreventivaUniversità degli Studi della Campania 'Luigi Vanvitelli'80121NaplesItaly
| | - G. Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO)FlorenceItaly
| | - A. May
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - E. Monninkhof
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - S. Christakoudi
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Inflammation BiologySchool of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - A. K. Heath
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - A. Agudo
- Unit of Nutrition and CancerCatalan Institute of Oncology – ICOL'Hospitalet de LlobregatSpain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care ProgramBellvitge Biomedical Research Institute – IDIBELLL'Hospitalet de LlobregatSpain
| | - M. B. Schulze
- Department of Molecular EpidemiologyGerman Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- Institute of Nutritional ScienceUniversity of PotsdamNuthetalGermany
| | - J. Rothwell
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - C. Cadeau
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - S. Severi
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - E. Weiderpass
- International Agency for Research on CancerLyonFrance
| | - M. J. Gunter
- International Agency for Research on CancerLyonFrance
| | - L. Dossus
- International Agency for Research on CancerLyonFrance
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5
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Sedlmeier AM, Viallon V, Ferrari P, Peruchet-Noray L, Fontvieille E, Amadou A, Seyed Khoei N, Weber A, Baurecht H, Heath AK, Tsilidis K, Kaaks R, Katzke V, Inan-Eroglu E, Schulze MB, Overvad K, Bonet C, Ubago-Guisado E, Chirlaque MD, Ardanaz E, Perez-Cornago A, Pala V, Tumino R, Sacerdote C, Pasanisi F, Borch KB, Rylander C, Weiderpass E, Gunter MJ, Fervers B, Leitzmann MF, Freisling H. Body shape phenotypes of multiple anthropometric traits and cancer risk: a multi-national cohort study. Br J Cancer 2023; 128:594-605. [PMID: 36460776 PMCID: PMC9938222 DOI: 10.1038/s41416-022-02071-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Classical anthropometric traits may fail to fully represent the relationship of weight, adiposity, and height with cancer risk. We investigated the associations of body shape phenotypes with the risk of overall and site-specific cancers. METHODS We derived four distinct body shape phenotypes from principal component (PC) analysis on height, weight, body mass index (BMI), waist (WC) and hip circumferences (HC), and waist-to-hip ratio (WHR). The study included 340,152 men and women from 9 European countries, aged mostly 35-65 years at recruitment (1990-2000) in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS After a median follow-up of 15.3 years, 47,110 incident cancer cases were recorded. PC1 (overall adiposity) was positively associated with the risk of overall cancer, with a HR per 1 standard deviation (SD) increment equal to 1.07 (95% confidence interval 1.05 to 1.08). Positive associations were observed with 10 cancer types, with HRs (per 1 SD) ranging from 1.36 (1.30-1.42) for endometrial cancer to 1.08 (1.03-1.13) for rectal cancer. PC2 (tall stature with low WHR) was positively associated with the risk of overall cancer (1.03; 1.02-1.04) and five cancer types which were not associated with PC1. PC3 (tall stature with high WHR) was positively associated with the risk of overall cancer (1.04; 1.03-1.05) and 12 cancer types. PC4 (high BMI and weight with low WC and HC) was not associated with overall risk of cancer (1.00; 0.99-1.01). CONCLUSIONS In this multi-national study, distinct body shape phenotypes were positively associated with the incidence of 17 different cancers and overall cancer.
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Affiliation(s)
- Anja M Sedlmeier
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Vivian Viallon
- International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France
| | - Pietro Ferrari
- International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France
| | - Laia Peruchet-Noray
- International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Emma Fontvieille
- International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France
| | - Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - Nazlisadat Seyed Khoei
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Andrea Weber
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elif Inan-Eroglu
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Esther Ubago-Guisado
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - María-Dolores Chirlaque
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Department of Epidemiology, Regional Health Council, Murcia, Spain
- IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Eva Ardanaz
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Navarra Public Health Institute, IdiSNA, Pamplona, Spain
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE - ONLUS, Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | - Fabrizio Pasanisi
- Clinical Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Kristin B Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Charlotta Rylander
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France
| | - Marc J Gunter
- International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France.
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Zagkos L, Dib MJ, Pinto R, Gill D, Koskeridis F, Drenos F, Markozannes G, Elliott P, Zuber V, Tsilidis K, Dehghan A, Tzoulaki I. Associations of genetically predicted fatty acid levels across the phenome: A mendelian randomisation study. PLoS Med 2022; 19:e1004141. [PMID: 36580444 PMCID: PMC9799317 DOI: 10.1371/journal.pmed.1004141] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/18/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Fatty acids are important dietary factors that have been extensively studied for their implication in health and disease. Evidence from epidemiological studies and randomised controlled trials on their role in cardiovascular, inflammatory, and other diseases remains inconsistent. The objective of this study was to assess whether genetically predicted fatty acid concentrations affect the risk of disease across a wide variety of clinical health outcomes. METHODS AND FINDINGS The UK Biobank (UKB) is a large study involving over 500,000 participants aged 40 to 69 years at recruitment from 2006 to 2010. We used summary-level data for 117,143 UKB samples (base dataset), to extract genetic associations of fatty acids, and individual-level data for 322,232 UKB participants (target dataset) to conduct our discovery analysis. We studied potentially causal relationships of circulating fatty acids with 845 clinical diagnoses, using mendelian randomisation (MR) approach, within a phenome-wide association study (PheWAS) framework. Regression models in PheWAS were adjusted for sex, age, and the first 10 genetic principal components. External summary statistics were used for replication. When several fatty acids were associated with a health outcome, multivariable MR and MR-Bayesian method averaging (MR-BMA) was applied to disentangle their causal role. Genetic predisposition to higher docosahexaenoic acid (DHA) was associated with cholelithiasis and cholecystitis (odds ratio per mmol/L: 0.76, 95% confidence interval: 0.66 to 0.87). This was supported in replication analysis (FinnGen study) and by the genetically predicted omega-3 fatty acids analyses. Genetically predicted linoleic acid (LA), omega-6, polyunsaturated fatty acids (PUFAs), and total fatty acids (total FAs) showed positive associations with cardiovascular outcomes with support from replication analysis. Finally, higher genetically predicted levels of DHA (0.83, 0.73 to 0.95) and omega-3 (0.83, 0.75 to 0.92) were found to have a protective effect on obesity, which was supported using body mass index (BMI) in the GIANT consortium as replication analysis. Multivariable MR analysis suggested a direct detrimental effect of LA (1.64, 1.07 to 2.50) and omega-6 fatty acids (1.81, 1.06 to 3.09) on coronary heart disease (CHD). MR-BMA prioritised LA and omega-6 fatty acids as the top risk factors for CHD. Although we present a range of sensitivity analyses to the address MR assumptions, horizontal pleiotropy may still bias the reported associations and further evaluation in clinical trials is needed. CONCLUSIONS Our study suggests potentially protective effects of circulating DHA and omega-3 concentrations on cholelithiasis and cholecystitis and on obesity, highlighting the need to further assess them as prevention treatments in clinical trials. Moreover, our findings do not support the supplementation of unsaturated fatty acids for cardiovascular disease prevention.
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Affiliation(s)
- Loukas Zagkos
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Marie-Joe Dib
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Rui Pinto
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- UK Dementia Research Institute, Imperial College London, London, United Kingdom
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Chief Scientific Advisor Office, Research and Early Development, Novo Nordisk, Copenhagen, Denmark
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
| | - Fotios Koskeridis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Fotios Drenos
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- UK Dementia Research Institute, Imperial College London, London, United Kingdom
- BHF Centre of Excellence at Imperial College London, London, United Kingdom
| | - Verena Zuber
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- UK Dementia Research Institute, Imperial College London, London, United Kingdom
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- UK Dementia Research Institute, Imperial College London, London, United Kingdom
| | - Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- UK Dementia Research Institute, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
- BHF Centre of Excellence at Imperial College London, London, United Kingdom
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7
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Breeur M, Ferrari P, Dossus L, Jenab M, Johansson M, Rinaldi S, Travis RC, His M, Key TJ, Schmidt JA, Overvad K, Tjønneland A, Kyrø C, Rothwell JA, Laouali N, Severi G, Kaaks R, Katzke V, Schulze MB, Eichelmann F, Palli D, Grioni S, Panico S, Tumino R, Sacerdote C, Bueno-de-Mesquita B, Olsen KS, Sandanger TM, Nøst TH, Quirós JR, Bonet C, Barranco MR, Chirlaque MD, Ardanaz E, Sandsveden M, Manjer J, Vidman L, Rentoft M, Muller D, Tsilidis K, Heath AK, Keun H, Adamski J, Keski-Rahkonen P, Scalbert A, Gunter MJ, Viallon V. Pan-cancer analysis of pre-diagnostic blood metabolite concentrations in the European Prospective Investigation into Cancer and Nutrition. BMC Med 2022; 20:351. [PMID: 36258205 PMCID: PMC9580145 DOI: 10.1186/s12916-022-02553-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological studies of associations between metabolites and cancer risk have typically focused on specific cancer types separately. Here, we designed a multivariate pan-cancer analysis to identify metabolites potentially associated with multiple cancer types, while also allowing the investigation of cancer type-specific associations. METHODS We analysed targeted metabolomics data available for 5828 matched case-control pairs from cancer-specific case-control studies on breast, colorectal, endometrial, gallbladder, kidney, localized and advanced prostate cancer, and hepatocellular carcinoma nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. From pre-diagnostic blood levels of an initial set of 117 metabolites, 33 cluster representatives of strongly correlated metabolites and 17 single metabolites were derived by hierarchical clustering. The mutually adjusted associations of the resulting 50 metabolites with cancer risk were examined in penalized conditional logistic regression models adjusted for body mass index, using the data-shared lasso penalty. RESULTS Out of the 50 studied metabolites, (i) six were inversely associated with the risk of most cancer types: glutamine, butyrylcarnitine, lysophosphatidylcholine a C18:2, and three clusters of phosphatidylcholines (PCs); (ii) three were positively associated with most cancer types: proline, decanoylcarnitine, and one cluster of PCs; and (iii) 10 were specifically associated with particular cancer types, including histidine that was inversely associated with colorectal cancer risk and one cluster of sphingomyelins that was inversely associated with risk of hepatocellular carcinoma and positively with endometrial cancer risk. CONCLUSIONS These results could provide novel insights for the identification of pathways for cancer development, in particular those shared across different cancer types.
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Affiliation(s)
- Marie Breeur
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Mazda Jenab
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Mattias Johansson
- Genetics Branch, International Agency for Research on Cancer, 69372 CEDEX 08, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Mathilde His
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Tim J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, DK-8200, Aarhus N, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, DK-8000, Aarhus C, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center Diet, Genes and Environment Nutrition and Biomarkers, DK-2100, Copenhagen, Denmark
| | - Cecilie Kyrø
- Danish Cancer Society Research Center Diet, Genes and Environment Nutrition and Biomarkers, DK-2100, Copenhagen, Denmark
| | - Joseph A Rothwell
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, "Exposome and Heredity" team, Gustave Roussy, 94800, Villejuif, France
| | - Nasser Laouali
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, "Exposome and Heredity" team, Gustave Roussy, 94800, Villejuif, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, "Exposome and Heredity" team, Gustave Roussy, 94800, Villejuif, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition, 14558, Nuthetal, Germany
| | - Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition, 14558, Nuthetal, Germany
- German Center for Diabetes Research (DZD), 85764, Neuherberg, Germany
| | - Domenico Palli
- Institute of Cancer Research, Prevention and Clinical Network (ISPRO), 50139, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133, Milan, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, 80131, Naples, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE-ONLUS, 97100, Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology Città della Salute e della Scienza University-Hospital, 10126, Turin, Italy
| | - Bas Bueno-de-Mesquita
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720, BA, Bilthoven, The Netherlands
| | - Karina Standahl Olsen
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
| | | | - Therese Haugdahl Nøst
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
| | - J Ramón Quirós
- Public Health Directorate, 33006, Oviedo, Asturias, Spain
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - Miguel Rodríguez Barranco
- Escuela Andaluza de Salud Pública (EASP), 18011, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - María-Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, 30003, Murcia, Spain
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Navarra Public Health Institute, 31003, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008, Pamplona, Spain
| | - Malte Sandsveden
- Department of Clinical Sciences Malmö Lund University, SE-214 28, Malmö, Sweden
| | - Jonas Manjer
- Departement of Surgery, Skåne University Hospital Malmö, Lund University, SE-214 28, Malmö, Sweden
| | - Linda Vidman
- Department of Radiation Sciences, Oncology Umeå University, SE-901 87, Umeå, Sweden
| | - Matilda Rentoft
- Department of Radiation Sciences, Oncology Umeå University, SE-901 87, Umeå, Sweden
| | - David Muller
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Hector Keun
- Department of Surgery and Cancer, Cancer Metabolism and Systems Toxicology Group, Division of Cancer, Imperial College London, London, SW7 2AZ, UK
| | - Jerzy Adamski
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Pekka Keski-Rahkonen
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Augustin Scalbert
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France
| | - Vivian Viallon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, NME Branch, 69372 CEDEX 08, Lyon, France.
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8
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Filis P, Mauri D, Markozannes G, Tolia M, Filis N, Tsilidis K. Hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of primary advanced and recurrent ovarian cancer: a systematic review and meta-analysis of randomized trials. ESMO Open 2022; 7:100586. [PMID: 36116421 PMCID: PMC9588894 DOI: 10.1016/j.esmoop.2022.100586] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/12/2022] [Accepted: 08/13/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction Ovarian cancer is the most lethal gynecologic malignancy. Although treatment with hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promising results, its role remains elusive. The aim of this study was to assess the comprehensive randomized evidence for the use versus non-use of HIPEC in primary and recurrent ovarian cancer. Materials and methods The Medline, Embase and Cochrane databases, as well as the European Society for Medical Oncology (ESMO) and American Society of Clinical Oncology (ASCO) conference abstracts of the last 5 years, were scrutinized in January 2022 for randomized, controlled trials that studied the use of HIPEC in ovarian cancer. Overall survival (OS), disease-free survival (DFS) and progression-free survival, as well as post-operative morbidity were the outcomes of interest. This study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Results Six randomized, controlled trials that randomized 737 patients were included in our analysis; of these, four studies (519 patients) were in primary and two (218 patients) in recurrent settings. In primary ovarian cancer, the combination of HIPEC with interval cytoreductive surgery (CRS) and neoadjuvant chemotherapy significantly improved the 5-year OS [393 patients, risk ratio (RR) = 0.77; 95% confidence interval (CI) 0.67-0.90; P value = 0.001] and DFS (hazard ratio = 0.60; 95% CI 0.41-0.87; P value = 0.008) compared with standard treatment alone. In the absence of neoadjuvant chemotherapy, the use of HIPEC + CRS was not associated with any survival advantage (126 patients, 4-year OS, RR = 0.93; 95% CI 0.57-1.53; P value = 0.781), but the sample size was smaller in this subset. Use of HIPEC in recurrent ovarian cancer did not provide any survival advantage (5-year OS: 218 patients, RR = 0.85; 95% CI 0.45-1.62; P value = 0.626). The risk for grade ≥3 adverse events was similar between HIPEC and no HIPEC (RR = 1.08; 95% CI 0.98-1.18; P value = 0.109). Conclusions In primary ovarian cancer the combination of HIPEC with interval CRS and neoadjuvant chemotherapy is a safe option that significantly improved 5-year OS and DFS. Its use in other settings should continue to be considered investigational. Addition of HIPEC to a complete cytoreductive surgery could be a valid treatment option for advanced ovarian cancer. HIPEC following neoadjuvant chemotherapy significantly increases 5-year overall survival in primary advanced ovarian cancer. HIPEC following neoadjuvant chemotherapy significantly increases disease-free survival in primary advanced ovarian cancer. HIPEC is a safe treatment option in ovarian cancer.
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Affiliation(s)
- P Filis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece; Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - D Mauri
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece.
| | - G Markozannes
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece; Department of Epidemiology and Biostatistics, St. Mary's Campus, School of Public Health, Imperial College London, London, UK
| | - M Tolia
- Department of Radiotherapy, School of Medicine, University of Crete, Heraklion, Greece
| | - N Filis
- Medical School, University of Ioannina, Ioannina, Greece
| | - K Tsilidis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece; Department of Epidemiology and Biostatistics, St. Mary's Campus, School of Public Health, Imperial College London, London, UK
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9
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Mauri D, Filis P, Markozannes G, Filis N, Tsilidis K. 540P Hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of primary advanced and recurrent ovarian cancer: A systematic review and meta-analysis of randomized trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hermelink R, Leitzmann MF, Markozannes G, Tsilidis K, Pukrop T, Berger F, Baurecht H, Jochem C. Sedentary behavior and cancer-an umbrella review and meta-analysis. Eur J Epidemiol 2022; 37:447-460. [PMID: 35612669 PMCID: PMC9209390 DOI: 10.1007/s10654-022-00873-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 04/11/2022] [Indexed: 12/24/2022]
Abstract
Several systematic reviews and meta-analyses have summarized the association between sedentary behavior (SB) and cancer. However, the level of evidence and the potential for risk of bias remains unclear. This umbrella review summarized the current data on SB in relation to cancer incidence and mortality, with a particular emphasis on assessing the risk of bias. We searched PubMed, Web of Science and Cochrane Database for systematic reviews and meta-analyses on the association between SB and cancer incidence and mortality. We also searched for recent observational studies not yet included in existing meta-analyses. We re-calculated summary risk estimates for cancer incidence and mortality using random effects models. We included 14 meta-analyses covering 17 different cancer sites from 77 original studies. We found that high SB levels increase the risk for developing ovarian, endometrial, colon, breast, prostate, and rectal cancers, with relative risks of 1.29 (95% confidence interval (CI) = 1.08-1.56), 1.29 (95% CI = 1.16-1.45), 1.25 (95% CI = 1.16-1.33), 1.08 (95% CI = 1.04-1.11), 1.08 (95% CI = 1.00-1.17), and 1.07 (95% CI = 1.01-1.12), respectively. Also, we found an increased risk of cancer mortality of 1.18 (95% CI = 1.09-1.26). Most associations between SB and specific cancer sites were supported by a "suggestive" level of evidence. High levels of SB are associated with increased risk of several types of cancer and increased cancer mortality risk.
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Affiliation(s)
- Rafael Hermelink
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany. .,Department of Internal Medicine II-Gastroenterology, University Hospital Munich, Munich, Germany.
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina, Ioannina, Greece.,Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, UK
| | - Kostas Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina, Ioannina, Greece.,Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, UK
| | - Tobias Pukrop
- Department of Haematology and Internal Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - Felix Berger
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Carmen Jochem
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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11
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Li D, Lu Y, Yuan S, Cai X, He Y, Chen J, Wu Q, He D, Fang A, Bo Y, Song P, Bogaert D, Tsilidis K, Larsson SC, Yu H, Zhu H, Theodoratou E, Zhu Y, Li X. Gut microbiota-derived metabolite trimethylamine-N-oxide and multiple health outcomes: an umbrella review and updated meta-analysis. Am J Clin Nutr 2022; 116:230-243. [PMID: 35348578 PMCID: PMC9257469 DOI: 10.1093/ajcn/nqac074] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Trimethylamine-N-oxide (TMAO) is a gut microbiota-derived metabolite produced from dietary nutrients. Many studies have discovered that circulating TMAO concentrations are linked to a wide range of health outcomes. OBJECTIVES This study aimed to summarize health outcomes related to circulating TMAO concentrations. METHODS We searched the Embase, Medline, Web of Science, and Scopus databases from inception to 15 February, 2022 to identify and update meta-analyses examining the associations between TMAO and multiple health outcomes. For each health outcome, we estimated the summary effect size, 95% prediction CI, between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate the evidence credibility of the identified associations. RESULTS This umbrella review identified 24 meta-analyses that investigated the association between circulating TMAO concentrations and health outcomes including all-cause mortality, cardiovascular diseases (CVDs), diabetes mellitus (DM), cancer, and renal function. We updated these meta-analyses by including a total of 82 individual studies on 18 unique health outcomes. Among them, 14 associations were nominally significant. After evidence credibility assessment, we found 6 (33%) associations (i.e., all-cause mortality, CVD mortality, major adverse cardiovascular events, hypertension, DM, and glomerular filtration rate) to present highly suggestive evidence. CONCLUSIONS TMAO might be a novel biomarker related to human health conditions including all-cause mortality, hypertension, CVD, DM, cancer, and kidney function. Further studies are needed to investigate whether circulating TMAO concentrations could be an intervention target for chronic disease.This review was registered at www.crd.york.ac.uk/prospero/ as CRD42021284730.
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Affiliation(s)
- Doudou Li
- Department of Big Data in Health Science, School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Lu
- Department of Big Data in Health Science, School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuai Yuan
- Department of Big Data in Health Science, School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Xiaxia Cai
- Department of Nutrition and Food Hygiene, Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Yuan He
- National Research Institute for Health and Family Planning, Beijing, China
| | - Jie Chen
- Department of Big Data in Health Science, School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiong Wu
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Di He
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Aiping Fang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Debby Bogaert
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden,Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Huanling Yu
- Department of Nutrition and Food Hygiene, Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Huilian Zhu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom,Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Yimin Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue Li
- Address correspondence to XL (E-mail: )
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12
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Laine JE, Huybrechts I, Gunter MJ, Ferrari P, Weiderpass E, Tsilidis K, Aune D, Schulze MB, Bergmann M, Temme EHM, Boer JMA, Agnoli C, Ericson U, Stubbendorff A, Ibsen DB, Dahm CC, Deschasaux M, Touvier M, Kesse-Guyot E, Sánchez Pérez MJ, Rodríguez Barranco M, Tong TYN, Papier K, Knuppel A, Boutron-Ruault MC, Mancini F, Severi G, Srour B, Kühn T, Masala G, Agudo A, Skeie G, Rylander C, Sandanger TM, Riboli E, Vineis P. Co-benefits from sustainable dietary shifts for population and environmental health: an assessment from a large European cohort study. Lancet Planet Health 2021; 5:e786-e796. [PMID: 34688354 PMCID: PMC8581185 DOI: 10.1016/s2542-5196(21)00250-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/08/2021] [Accepted: 08/20/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Unhealthy diets, the rise of non-communicable diseases, and the declining health of the planet are highly intertwined, where food production and consumption are major drivers of increases in greenhouse gas emissions, substantial land use, and adverse health such as cancer and mortality. To assess the potential co-benefits from shifting to more sustainable diets, we aimed to investigate the associations of dietary greenhouse gas emissions and land use with all-cause and cause-specific mortality and cancer incidence rates. METHODS Using data from 443 991 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a multicentre prospective cohort, we estimated associations between dietary contributions to greenhouse gas emissions and land use and all-cause and cause-specific mortality and incident cancers using Cox proportional hazards regression models. The main exposures were modelled as quartiles. Co-benefits, encompassing the potential effects of alternative diets on all-cause mortality and cancer and potential reductions in greenhouse gas emissions and land use, were estimated with counterfactual attributable fraction intervention models, simulating potential effects of dietary shifts based on the EAT-Lancet reference diet. FINDINGS In the pooled analysis, there was an association between levels of dietary greenhouse gas emissions and all-cause mortality (adjusted hazard ratio [HR] 1·13 [95% CI 1·10-1·16]) and between land use and all-cause mortality (1·18 [1·15-1·21]) when comparing the fourth quartile to the first quartile. Similar associations were observed for cause-specific mortality. Associations were also observed between all-cause cancer incidence rates and greenhouse gas emissions, when comparing the fourth quartile to the first quartile (adjusted HR 1·11 [95% CI 1·09-1·14]) and between all-cause cancer incidence rates and land use (1·13 [1·10-1·15]); however, estimates differed by cancer type. Through counterfactual attributable fraction modelling of shifts in levels of adherence to the EAT-Lancet diet, we estimated that up to 19-63% of deaths and up to 10-39% of cancers could be prevented, in a 20-year risk period, by different levels of adherence to the EAT-Lancet reference diet. Additionally, switching from lower adherence to the EAT-Lancet reference diet to higher adherence could potentially reduce food-associated greenhouse gas emissions up to 50% and land use up to 62%. INTERPRETATION Our results indicate that shifts towards universally sustainable diets could lead to co-benefits, such as minimising diet-related greenhouse gas emissions and land use, reducing the environmental footprint, aiding in climate change mitigation, and improving population health. FUNDING European Commission (DG-SANCO), the International Agency for Research on Cancer (IARC), MRC Early Career Fellowship (MR/M501669/1).
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Affiliation(s)
- Jessica E Laine
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK.
| | | | - Marc J Gunter
- International Agency for Research on Cancer, Lyon, France
| | - Pietro Ferrari
- International Agency for Research on Cancer, Lyon, France
| | | | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Matthias B Schulze
- Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
| | - Manuela Bergmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Elisabeth H M Temme
- Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Jolanda M A Boer
- Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Claudia Agnoli
- Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Ulrika Ericson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Daniel B Ibsen
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Mélanie Deschasaux
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Maria-Jose Sánchez Pérez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Miguel Rodríguez Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Francesca Mancini
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, 94805, Villejuif, France
| | - Gianluca Severi
- CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Bernard Srour
- Division of Cancer Epidemiology, German Cancer Rsearch Center Heidelberg, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Rsearch Center Heidelberg, Heidelberg, Germany
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Charlotta Rylander
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK; Italian Institute of Technology, Genova, Italy
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13
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Katsoulis M, Lai AG, Diaz-Ordaz K, Gomes M, Pasea L, Banerjee A, Denaxas S, Tsilidis K, Lagiou P, Misirli G, Bhaskaran K, Wannamethee G, Dobson R, Batterham RL, Kipourou DK, Lumbers RT, Wen L, Wareham N, Langenberg C, Hemingway H. Identifying adults at high-risk for change in weight and BMI in England: a longitudinal, large-scale, population-based cohort study using electronic health records. Lancet Diabetes Endocrinol 2021; 9:681-694. [PMID: 34481555 PMCID: PMC8440227 DOI: 10.1016/s2213-8587(21)00207-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/17/2021] [Accepted: 07/20/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Targeted obesity prevention policies would benefit from the identification of population groups with the highest risk of weight gain. The relative importance of adult age, sex, ethnicity, geographical region, and degree of social deprivation on weight gain is not known. We aimed to identify high-risk groups for changes in weight and BMI using electronic health records (EHR). METHODS In this longitudinal, population-based cohort study we used linked EHR data from 400 primary care practices (via the Clinical Practice Research Datalink) in England, accessed via the CALIBER programme. Eligible participants were aged 18-74 years, were registered at a general practice clinic, and had BMI and weight measurements recorded between Jan 1, 1998, and June 30, 2016, during the period when they had eligible linked data with at least 1 year of follow-up time. We calculated longitudinal changes in BMI over 1, 5, and 10 years, and investigated the absolute risk and odds ratios (ORs) of transitioning between BMI categories (underweight, normal weight, overweight, obesity class 1 and 2, and severe obesity [class 3]), as defined by WHO. The associations of demographic factors with BMI transitions were estimated by use of logistic regression analysis, adjusting for baseline BMI, family history of cardiovascular disease, use of diuretics, and prevalent chronic conditions. FINDINGS We included 2 092 260 eligible individuals with more than 9 million BMI measurements in our study. Young adult age was the strongest risk factor for weight gain at 1, 5, and 10 years of follow-up. Compared with the oldest age group (65-74 years), adults in the youngest age group (18-24 years) had the highest OR (4·22 [95% CI 3·86-4·62]) and greatest absolute risk (37% vs 24%) of transitioning from normal weight to overweight or obesity at 10 years. Likewise, adults in the youngest age group with overweight or obesity at baseline were also at highest risk to transition to a higher BMI category; OR 4·60 (4·06-5·22) and absolute risk (42% vs 18%) of transitioning from overweight to class 1 and 2 obesity, and OR 5·87 (5·23-6·59) and absolute risk (22% vs 5%) of transitioning from class 1 and 2 obesity to class 3 obesity. Other demographic factors were consistently less strongly associated with these transitions; for example, the OR of transitioning from normal weight to overweight or obesity in people living in the most socially deprived versus least deprived areas was 1·23 (1·18-1·27), for men versus women was 1·12 (1·08-1·16), and for Black individuals versus White individuals was 1·13 (1·04-1·24). We provide an open access online risk calculator, and present high-resolution obesity risk charts over a 1-year, 5-year, and 10-year follow-up period. INTERPRETATION A radical shift in policy is required to focus on individuals at the highest risk of weight gain (ie, young adults aged 18-24 years) for individual-level and population-level prevention of obesity and its long-term consequences for health and health care. FUNDING The British Hearth Foundation, Health Data Research UK, the UK Medical Research Council, and the National Institute for Health Research.
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Affiliation(s)
- Michail Katsoulis
- Institute of Health Informatics, University College London, London, UK; Health Data Research UK, University College London, London, UK.
| | - Alvina G Lai
- Institute of Health Informatics, University College London, London, UK; Health Data Research UK, University College London, London, UK
| | - Karla Diaz-Ordaz
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Manuel Gomes
- Department of Applied Health Research, University College London, London, UK
| | - Laura Pasea
- Institute of Health Informatics, University College London, London, UK
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK; University College London Hospitals NHS Trust, London, UK; Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, UK; Health Data Research UK, University College London, London, UK; Alan Turing Institute, London, UK; National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, UK
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | | | - Krishnan Bhaskaran
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, UK
| | - Richard Dobson
- Health Data Research UK, University College London, London, UK; Institute of Health Informatics, University College London, London, UK; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rachel L Batterham
- Centre for Obesity Research, University College London, London, UK; National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, UK; University College London Hospitals Bariatric Centre for Weight Management and Metabolic Surgery, London, UK
| | - Dimitra-Kleio Kipourou
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - R Thomas Lumbers
- Institute of Health Informatics, University College London, London, UK; Health Data Research UK, University College London, London, UK
| | - Lan Wen
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK; Computational Medicine, Berlin Institute of Health, Charité-University Medicine Berlin, Berlin, Germany
| | - Harry Hemingway
- Institute of Health Informatics, University College London, London, UK; Health Data Research UK, University College London, London, UK; National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, UK
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14
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Dimou N, Kim AE, Flanagan O, Murphy N, Bouras E, Campbell PT, Casey G, Gallinger S, Gruber SB, Hsu L, Jenkins MA, Lin Y, Moreno V, Qu C, Ruiz-Narvaez E, Stern MC, Tian Y, Tsilidis K, Gauderman WJ, Gunter MJ, Peters U. Abstract 817: Probing the diabetes - colorectal cancer link using gene - environment interaction analyses. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Type 2 diabetes mellitus (T2D) is an established risk factor for colorectal cancer. However, the mechanisms underlying this relationship are unclear and it is not known if the association is modified by genetic variants. To provide insights into the molecular pathways potentially linking diabetes and colorectal cancer, we undertook a large-scale gene-environment interaction analysis (GxE).
Methods: We tested multiplicative statistical interactions between approximately 7 million common (allele frequency >1%) genetic variants and T2D status in 31,529 colorectal cancer cases and 42,861 controls of European ancestry from 3 genetic consortia (GECCO/CCFR/CORECT). Statistical methods included traditional case-control logistic regression, case-only analyses, joint tests (2df/3df), and two-step approaches. We also explored additive and multiplicative interactions between polygenic risk score (PRS) of the known genome-wide significant loci for colorectal cancer and T2D. Results: Overall, T2D was positively associated with colorectal cancer risk [odds ratio [OR]: 1.25 (95% confidence interval [CI]: 1.14-1.36)]. A statistically significant interaction was identified between T2D status and an intronic variant in LRCH1 (rs9526201) and colorectal cancer risk using the 2-d.f. joint test (p-value:1.44x10-8). A statistically significant additive scale interaction between PRS for colorectal cancer and T2D was found (p-value: 1.8x10-10) such that the observed risk of developing colorectal cancer for individuals with T2D and a 1 standard deviation (SD) higher increment of PRS compared to non-diabetics with the lowest PRS was 0.184 more than if there was no interaction between T2D and PRS. Conclusion: These results suggest that variation in a gene related to immune function may modify the association of T2D with colorectal cancer and potentially provide novel insights into the biology underlying this relationship. Furthermore, our data show that genetic risk prediction models for CRC may need to consider non-genetic risk factors.
Citation Format: Niki Dimou, Andre E. Kim, Orlagh Flanagan, Neil Murphy, Emmanouil Bouras, Peter T. Campbell, Graham Casey, Steven Gallinger, Stephen B. Gruber, Li Hsu, Mark A. Jenkins, Yi Lin, Victor Moreno, Conghui Qu, Edward Ruiz-Narvaez, Mariana C. Stern, Yu Tian, Kostas Tsilidis, W. James Gauderman, Marc J. Gunter, Ulrike Peters. Probing the diabetes - colorectal cancer link using gene - environment interaction analyses [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 817.
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Affiliation(s)
- Niki Dimou
- 1Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Andre E. Kim
- 2Department of Preventive Medicine & USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Orlagh Flanagan
- 1Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Neil Murphy
- 1Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Emmanouil Bouras
- 3Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Peter T. Campbell
- 4Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Graham Casey
- 5Center for Public Health Genomics, University of Virginia, Charlottesville, VA
| | - Steven Gallinger
- 6Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Stephen B. Gruber
- 2Department of Preventive Medicine & USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Li Hsu
- 7Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mark A. Jenkins
- 8Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Yi Lin
- 7Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Victor Moreno
- 9Oncology Data Analytics Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Conghui Qu
- 7Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Edward Ruiz-Narvaez
- 10Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Mariana C. Stern
- 2Department of Preventive Medicine & USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Yu Tian
- 11Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Kostas Tsilidis
- 12Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, United Kingdom
| | - W. James Gauderman
- 2Department of Preventive Medicine & USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Marc J. Gunter
- 1Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Ulrike Peters
- 7Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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15
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Jayasekara H, MacInnis RJ, Lujan‐Barroso L, Mayen‐Chacon A, Cross AJ, Wallner B, Palli D, Ricceri F, Pala V, Panico S, Tumino R, Kühn T, Kaaks R, Tsilidis K, Sánchez M, Amiano P, Ardanaz E, Chirlaque López MD, Merino S, Rothwell JA, Boutron‐Ruault M, Severi G, Sternby H, Sonestedt E, Bueno‐de‐Mesquita B, Boeing H, Travis R, Sandanger TM, Trichopoulou A, Karakatsani A, Peppa E, Tjønneland A, Yang Y, Hodge AM, Mitchell H, Haydon A, Room R, Hopper JL, Weiderpass E, Gunter MJ, Riboli E, Giles GG, Milne RL, Agudo A, English DR, Ferrari P. Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer: A pooled analysis of data from two prospective cohort studies. Int J Cancer 2021; 148:2759-2773. [PMID: 33554339 PMCID: PMC9290950 DOI: 10.1002/ijc.33504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 02/03/2023]
Abstract
Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long-term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491 714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group-based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. In all, 1225 incident stomach cancers (78% noncardia) were diagnosed over 7 094 637 person-years; 984 in 382 957 study participants with lifetime alcohol intake data (5 455 507 person-years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with noncardia cancer (HR = 1.03, 95% CI: 1.00-1.06 per 10 g/d increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/d compared to 0.1 to 4.9 g/d. A weak inverse association with cardia cancer (HR = 0.93, 95% CI: 0.87-1.00) was also observed. HRs of 1.48 (95% CI: 1.10-1.99) for noncardia and 0.51 (95% CI: 0.26-1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared to light stable intake (Phomogeneity = .02). These associations did not differ appreciably by smoking or H pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent noncardia stomach cancer. Heterogeneous associations observed for cardia and noncardia cancers may indicate etiologic differences.
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Affiliation(s)
- Harindra Jayasekara
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraVictoriaAustralia
| | - Robert J. MacInnis
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
| | - Leila Lujan‐Barroso
- Unit of Nutrition and Cancer, Catalan Institute of Oncology ‐ ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute ‐ IDIBELL, L'Hospitalet de LlobregatBarcelonaSpain
- Department of Nursing of Public HealthMental Health and Maternity and Child Health School of Nursing Universitat de BarcelonaBarcelonaSpain
| | - Ana‐Lucia Mayen‐Chacon
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, World Health OrganizationLyonFrance
| | - Amanda J. Cross
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Bengt Wallner
- Department of Surgical and Perioperatve Sciences, SurgeryUmeå University HospitalUmeåSweden
| | - Domenico Palli
- Cancer Risk Factors and Life‐Style Epidemiology UnitInstitute for Cancer Research, Prevention and Clinical Network – ISPROFlorenceItaly
| | - Fulvio Ricceri
- Department of Clinical and Biological SciencesUniversity of TurinTurinItaly
- Unit of Epidemiology, Regional Health Service ASL TO3GrugliascoItaly
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di MilanoMilanItaly
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e ChirurgiaFederico II UniversityNaplesItaly
| | - Rosario Tumino
- Cancer Registry and Histopathology DepartmentProvincial Health Authority (ASP)RagusaItaly
| | - Tilman Kühn
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Kostas Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Maria‐Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP)GranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- CIBER in Epidemiology and Public Health (CIBERESP)MadridSpain
- Universidad de GranadaGranadaSpain
| | - Pilar Amiano
- CIBER in Epidemiology and Public Health (CIBERESP)MadridSpain
- Public Health Division of Gipuzkoa, BioDonostia Research InstituteDonostia‐San SebastianSpain
| | - Eva Ardanaz
- CIBER in Epidemiology and Public Health (CIBERESP)MadridSpain
- Navarra Public Health InstitutePamplonaSpain
- IdiSNA, Navarra Institute for Health ResearchPamplonaSpain
| | - María Dolores Chirlaque López
- CIBER in Epidemiology and Public Health (CIBERESP)MadridSpain
- Department of EpidemiologyRegional Health Council, IMIB‐Arrixaca, Murcia UniversityMurciaSpain
| | - Susana Merino
- Public Health Directorate, Regional Government of AsturiasOviedoSpain
| | - Joseph A. Rothwell
- CESP (U1018), Faculté de médecineUniversité Paris‐Saclay, UVSQ, INSERMVillejuifFrance
- Gustave RoussyVillejuifFrance
| | | | - Gianluca Severi
- CESP (U1018), Faculté de médecineUniversité Paris‐Saclay, UVSQ, INSERMVillejuifFrance
- Gustave RoussyVillejuifFrance
- Department of StatisticsComputer Science and Applications “G. Parenti” (DISIA), University of FlorenceFlorenceItaly
| | - Hanna Sternby
- Department of SurgeryInstitution of Clinical Sciences Malmö, Lund UniversityLundSweden
| | - Emily Sonestedt
- Nutritional Epidemiology, Department of Clinical Sciences MalmöLund UniversityMalmöSweden
| | - Bas Bueno‐de‐Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - Heiner Boeing
- Institute of Nutrition Science, University of PotsdamNuthetalGermany
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Torkjel M. Sandanger
- Department of Community Medicine, Faculty of Health SciencesUiT‐the Arctic University of NorwayTromsøNorway
| | | | - Anna Karakatsani
- Hellenic Health FoundationAthensGreece
- 2nd Pulmonary Medicine DepartmentSchool of Medicine, National Kapodistrian University of Athens, “ATTIKON” University HospitalHaidariGreece
| | | | - Anne Tjønneland
- Danish Cancer Society Research CenterCopenhagenDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Yi Yang
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
| | - Allison M. Hodge
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
| | - Hazel Mitchell
- School of Biotechnology and Biomolecular Sciences, University of New South WalesKensingtonNew South WalesAustralia
| | - Andrew Haydon
- Department of Medical OncologyAlfred HospitalMelbourneVictoriaAustralia
| | - Robin Room
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraVictoriaAustralia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health SciencesStockholm UniversityStockholmSweden
| | - John L. Hopper
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer, World Health OrganizationLyonFrance
| | - Marc J. Gunter
- Nutritional Epidemiology Group, International Agency for Research on Cancer, World Health OrganizationLyonFrance
| | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Graham G. Giles
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash UniversityClaytonVictoriaAustralia
| | - Roger L. Milne
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash UniversityClaytonVictoriaAustralia
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology ‐ ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute ‐ IDIBELL, L'Hospitalet de LlobregatBarcelonaSpain
| | - Dallas R. English
- Cancer Epidemiology DivisionCancer Council VictoriaMelbourneVictoriaAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVictoriaAustralia
| | - Pietro Ferrari
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, World Health OrganizationLyonFrance
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16
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Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide. Lifestyle changes are at the forefront of preventing the disease. This includes advice such as increasing physical activity and having a healthy balanced diet to reduce risk factors. Intermittent fasting (IF) is a popular dietary plan involving restricting caloric intake to certain days in the week such as alternate day fasting and periodic fasting, and restricting intake to a number of hours in a given day, otherwise known as time-restricted feeding. IF is being researched for its benefits and many randomised controlled trials have looked at its benefits in preventing CVD. OBJECTIVES To determine the role of IF in preventing and reducing the risk of CVD in people with or without prior documented CVD. SEARCH METHODS We conducted our search on 12 December 2019; we searched CENTRAL, MEDLINE and Embase. We also searched three trials registers and searched the reference lists of included papers. Systematic reviews were also viewed for additional studies. There was no language restriction applied. SELECTION CRITERIA We included randomised controlled trials comparing IF to ad libitum feeding (eating at any time with no specific caloric restriction) or continuous energy restriction (CER). Participants had to be over the age of 18 and included those with and without cardiometabolic risk factors. Intermittent fasting was categorised into alternate-day fasting, modified alternate-day fasting, periodic fasting and time-restricted feeding. DATA COLLECTION AND ANALYSIS Five review authors independently selected studies for inclusion and extraction. Primary outcomes included all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, and heart failure. Secondary outcomes include the absolute change in body weight, and glucose. Furthermore, side effects such as headaches and changes to the quality of life were also noted. For continuous data, pooled mean differences (MD) (with 95% confidence intervals (CIs)) were calculated. We contacted trial authors to obtain missing data. We used GRADE to assess the certainty of the evidence. MAIN RESULTS: Our search yielded 39,165 records after the removal of duplicates. From this, 26 studies met our criteria, and 18 were included in the pooled analysis. The 18 studies included 1125 participants and observed outcomes ranging from four weeks to six months. No studies included data on all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, and heart failure at any point during follow-up. Of quantitatively analysed data, seven studies compared IF with ab libitum feeding, eight studies compared IF with CER, and three studies compared IF with both ad libitum feeding and CER. Outcomes were reported at short term (≤ 3 months) and medium term (> 3 months to 12 months) follow-up. Body weight was reduced with IF compared to ad libitum feeding in the short term (MD -2.88 kg, 95% CI -3.96 to -1.80; 224 participants; 7 studies; low-certainty evidence). We are uncertain of the effect of IF when compared to CER in the short term (MD -0.88 kg, 95% CI -1.76 to 0.00; 719 participants; 10 studies; very low-certainty evidence) and there may be no effect in the medium term (MD -0.56 kg, 95% CI -1.68 to 0.56; 279 participants; 4 studies; low-certainty evidence). We are uncertain about the effect of IF on glucose when compared to ad libitum feeding in the short term (MD -0.03 mmol/L, 95% CI -0.26 to 0.19; 95 participants; 3 studies; very-low-certainty of evidence) and when compared to CER in the short term: MD -0.02 mmol/L, 95% CI -0.16 to 0.12; 582 participants; 9 studies; very low-certainty; medium term: MD 0.01, 95% CI -0.10 to 0.11; 279 participants; 4 studies; low-certainty evidence). The changes in body weight and glucose were not deemed to be clinically significant. Four studies reported data on side effects, with some participants complaining of mild headaches. One study reported on the quality of life using the RAND SF-36 score. There was a modest increase in the physical component summary score. AUTHORS' CONCLUSIONS Intermittent fasting was seen to be superior to ad libitum feeding in reducing weight. However, this was not clinically significant. There was no significant clinical difference between IF and CER in improving cardiometabolic risk factors to reduce the risk of CVD. Further research is needed to understand the safety and risk-benefit analysis of IF in specific patient groups (e.g. patients with diabetes or eating disorders) as well as the effect on longer-term outcomes such as all-cause mortality and myocardial infarction.
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Affiliation(s)
| | | | | | | | - Sadia Zaman
- School of Medicine, Imperial College London, London, UK
| | - Abdul-Majeed Salmasi
- Department of Cardiology, London North West University Healthcare NHS Trust, London, UK
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Abbas Dehghan
- School of Public Health, Imperial College London, London, UK
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17
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Assi N, Rinaldi S, Viallon V, Dashti SG, Dossus L, Fournier A, Cervenka I, Kvaskoff M, Turzanski-Fortner R, Bergmann M, Boeing H, Panico S, Ricceri F, Palli D, Tumino R, Grioni S, José Sánchez Pérez M, Chirlaque MD, Bonet C, Barricarte Gurrea A, Amiano Etxezarreta P, Merino S, Bueno de Mesquita B, van Gils CH, Onland-Moret C, Tjønneland A, Overvad K, Trichopoulou A, Martimianaki G, Karakatsani A, Key T, Chistakoudi S, Ellingjord-Dale M, Tsilidis K, Riboli E, Kaaks R, Gunter MJ, Ferrari P. Mediation analysis of the alcohol-postmenopausal breast cancer relationship by sex hormones in the EPIC cohort. Int J Cancer 2020; 146:759-768. [PMID: 30968961 PMCID: PMC6786903 DOI: 10.1002/ijc.32324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/11/2019] [Accepted: 03/13/2019] [Indexed: 12/27/2022]
Abstract
Alcohol consumption is associated with higher risk of breast cancer (BC); however, the biological mechanisms underlying this association are not fully elucidated, particularly the extent to which this relationship is mediated by sex hormone levels. Circulating concentrations of estradiol, testosterone, their free fractions and sex-hormone binding globulin (SHBG), were examined in 430 incident BC cases and 645 matched controls among alcohol-consuming postmenopausal women nested within the European Prospective Investigation into Cancer and Nutrition. Mediation analysis was applied to assess whether individual hormone levels mediated the relationship between alcohol intake and BC risk. An alcohol-related hormonal signature, obtained by partial least square (PLS) regression, was evaluated as a potential mediator. Total (TE), natural direct and natural indirect effects (NIE) were estimated. Alcohol intake was positively associated with overall BC risk and specifically with estrogen receptor-positive tumors with respectively TE = 1.17(95%CI: 1.01,1.35) and 1.36(1.08,1.70) for a 1-standard deviation (1-SD) increase of intake. There was no evidence of mediation by sex steroids or SHBG separately except for a weak indirect effect through free estradiol where NIE = 1.03(1.00,1.06). However, an alcohol-related hormonal signature negatively associated with SHBG and positively with estradiol and testosterone was associated with BC risk (odds ratio [OR] = 1.25 [1.07,1.47]) for a 1-SD higher PLS score, and had a statistically significant NIE accounting for a mediated proportion of 24%. There was limited evidence of mediation of the alcohol-BC association by individual sex hormones. However, a hormonal signature, reflecting lower levels of SHBG and higher levels of sex steroids, mediated a substantial proportion of the association.
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Affiliation(s)
- Nada Assi
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Sabina Rinaldi
- Biomarkers Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Vivian Viallon
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - S. Ghazaleh Dashti
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
- Center for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Parkville, VIC, Australia
| | - Laure Dossus
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Agnès Fournier
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
- Nutritional Epidemiology Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Iris Cervenka
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | | | - Manuela Bergmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (TO), Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, “Civic -M.P.Arezzo” Hospital, ASP Ragusa, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
| | - María José Sánchez Pérez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria, IBS GRANADA, Universidad de Granada. Granada, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Institut Català d’Oncologia, Av. Granvia de L’Hospitalet 199-203, 08908 L’Hospitalet de Llobregat, Spain
| | - Aurelio Barricarte Gurrea
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Spain
| | - Pilar Amiano Etxezarreta
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institue, San Sebastian, Spain
| | | | - Bas Bueno de Mesquita
- Department. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, 50603, Kuala Lumpur, Malaysia
| | - Carla H. van Gils
- Julius Center for Health Sciences and Primary Care, Cancer Epidemiology University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, Cancer Epidemiology University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, DK 2100 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences,University of Copenhagen, Denmark
| | - Kim Overvad
- The Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark
| | | | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Haidari, Greece
| | - Tim Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Sofia Chistakoudi
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
- MRC Centre for Transplantation, King’s College London, Great Maze Pond, London SE1 9RT, United Kingdom
| | - Merete Ellingjord-Dale
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marc J Gunter
- Nutritional Epidemiology Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Pietro Ferrari
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
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18
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Allaf M, Elghazaly H, Mohamed OG, Fareen MFK, Zaman S, Salmasi AM, Tsilidis K, Dehghan A. Intermittent fasting for the prevention of cardiovascular disease. Cochrane Database Syst Rev 2019. [DOI: 10.1002/14651858.cd013496] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | | | - Sadia Zaman
- Imperial College London; School of Medicine; London UK
| | - Abdul-Majeed Salmasi
- London North West University Healthcare NHS Trust; Department of Cardiology; London UK
| | - Kostas Tsilidis
- Imperial College London; Department of Epidemiology and Biostatistics, School of Public Health; London UK
- University of Ioannina School of Medicine; Department of Hygiene and Epidemiology; Ioannina Greece
| | - Abbas Dehghan
- Imperial College London; School of Public Health; London UK
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19
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Fedirko V, Jenab M, Méplan C, Jones JS, Zhu W, Schomburg L, Siddiq A, Hybsier S, Overvad K, Tjønneland A, Omichessan H, Perduca V, Boutron-Ruault MC, Kühn T, Katzke V, Aleksandrova K, Trichopoulou A, Karakatsani A, Kotanidou A, Tumino R, Panico S, Masala G, Agnoli C, Naccarati A, Bueno-de-Mesquita B, Vermeulen RCH, Weiderpass E, Skeie G, Nøst TH, Lujan-Barroso L, Quirós JR, Huerta JM, Rodríguez-Barranco M, Barricarte A, Gylling B, Harlid S, Bradbury KE, Wareham N, Khaw KT, Gunter M, Murphy N, Freisling H, Tsilidis K, Aune D, Riboli E, Hesketh JE, Hughes DJ. Association of Selenoprotein and Selenium Pathway Genotypes with Risk of Colorectal Cancer and Interaction with Selenium Status. Nutrients 2019; 11:E935. [PMID: 31027226 PMCID: PMC6520820 DOI: 10.3390/nu11040935] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 12/16/2022] Open
Abstract
Selenoprotein genetic variations and suboptimal selenium (Se) levels may contribute to the risk of colorectal cancer (CRC) development. We examined the association between CRC risk and genotype for single nucleotide polymorphisms (SNPs) in selenoprotein and Se metabolic pathway genes. Illumina Goldengate assays were designed and resulted in the genotyping of 1040 variants in 154 genes from 1420 cases and 1421 controls within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Multivariable logistic regression revealed an association of 144 individual SNPs from 63 Se pathway genes with CRC risk. However, regarding the selenoprotein genes, only TXNRD1 rs11111979 retained borderline statistical significance after adjustment for correlated tests (PACT = 0.10; PACT significance threshold was P < 0.1). SNPs in Wingless/Integrated (Wnt) and Transforming growth factor (TGF) beta-signaling genes (FRZB, SMAD3, SMAD7) from pathways affected by Se intake were also associated with CRC risk after multiple testing adjustments. Interactions with Se status (using existing serum Se and Selenoprotein P data) were tested at the SNP, gene, and pathway levels. Pathway analyses using the modified Adaptive Rank Truncated Product method suggested that genes and gene x Se status interactions in antioxidant, apoptosis, and TGF-beta signaling pathways may be associated with CRC risk. This study suggests that SNPs in the Se pathway alone or in combination with suboptimal Se status may contribute to CRC development.
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Affiliation(s)
- Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health & Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA.
| | - Mazda Jenab
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Catherine Méplan
- School of Biomedical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
| | - Jeb S Jones
- Department of Epidemiology, Rollins School of Public Health & Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA.
| | - Wanzhe Zhu
- Department of Epidemiology, Rollins School of Public Health & Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA.
| | - Lutz Schomburg
- Institute for Experimental Endocrinology, University Medical School, D-13353 Berlin, Germany.
| | - Afshan Siddiq
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
| | - Sandra Hybsier
- Institute for Experimental Endocrinology, University Medical School, D-13353 Berlin, Germany.
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, 8000 Aarhus, Denmark.
| | - Anne Tjønneland
- Diet, Genes and Environment Unit, Danish Cancer Society Research Center, DK 2100 Copenhagen, Denmark.
| | - Hanane Omichessan
- Faculty of Medicine, CESP, University of Paris-Sud, Faculty of Medicine UVSQ, INSERM, University of Paris-Saclay, 94805 Villejuif, France.
- Centre for Research in Epidemiology and Population Health (CESP), F-94805 Gustave Roussy, Villejuif, France.
| | - Vittorio Perduca
- Faculty of Medicine, CESP, University of Paris-Sud, Faculty of Medicine UVSQ, INSERM, University of Paris-Saclay, 94805 Villejuif, France.
- Centre for Research in Epidemiology and Population Health (CESP), F-94805 Gustave Roussy, Villejuif, France.
- Laboratory of Applied Mathematics, MAP5 (UMR CNRS 8145), University of Paris Descartes, 75270 Paris, France.
| | - Marie-Christine Boutron-Ruault
- Faculty of Medicine, CESP, University of Paris-Sud, Faculty of Medicine UVSQ, INSERM, University of Paris-Saclay, 94805 Villejuif, France.
- Centre for Research in Epidemiology and Population Health (CESP), F-94805 Gustave Roussy, Villejuif, France.
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), 69120 Heidelberg, Germany.
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), 69120 Heidelberg, Germany.
| | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany.
| | | | - Anna Karakatsani
- Hellenic Health Foundation, 115 27 Athens, Greece.
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, 106 79 Haidari, Greece.
| | - Anastasia Kotanidou
- Hellenic Health Foundation, 115 27 Athens, Greece.
- 1st Department of Critical Care Medicine and Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, 106 76 Athens, Greece.
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Civic M.P. Arezzo Hospital, 97100 Ragusa, Italy.
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, Federico II University, 80138 Naples, Italy.
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, 50141 Florence, Italy.
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, IRCCS Foundation National Cancer Institute, 20133 Milan, Italy.
| | - Alessio Naccarati
- Molecular and Genetic Epidemiology Unit, Italian Institute for Genomic Medicine (IIGM) Torino, 10126 Torino, Italy.
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands.
- Department of Gastroenterology and Hepatology, University Medical Centre, 3584 CX Utrecht, The Netherlands.
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Roel C H Vermeulen
- Institute of Risk Assessment Sciences, Utrecht University, 3512 JE Utrecht, The Netherlands.
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, N-0304 Oslo, Norway.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, SE-171 77 Stockholm, Sweden.
- Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, Helsinki University, 00014 Helsinki, Finland.
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 9019 Tromsø, Norway.
| | - Guri Skeie
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 9019 Tromsø, Norway.
| | - Therese Haugdahl Nøst
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, 9019 Tromsø, Norway.
| | - Leila Lujan-Barroso
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - J Ramón Quirós
- EPIC Asturias, Public Health Directorate, 33006 Oviedo, Asturias, Spain.
| | - José María Huerta
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, 30008 Murcia, Spain.
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
| | - Miguel Rodríguez-Barranco
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Andalucia School of Public Health, Institute for Biosanitary Research, University Hospital of Granada, University of Granada, 18011 Granada, Spain.
| | - Aurelio Barricarte
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Epidemiology, Prevention and Promotion Health Service, Navarra Public Health Institute, 31003 Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
| | - Björn Gylling
- Department of Medical Biosciences, Pathology, Umea University, 901 87 Umea, Sweden.
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Umea University, 901 87 Umea, Sweden.
| | - Kathryn E Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, CB2 0QQ Cambridge, UK.
| | - Kay-Tee Khaw
- School of Clinical Medicine, University of Cambridge, Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
| | - Marc Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Heinz Freisling
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110 Ioannina, Greece.
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
- Department of Nutrition, Bjørknes University College, 0456 Oslo, Norway.
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, 0372 Oslo, Norway.
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
| | - John E Hesketh
- School of Biomedical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
| | - David J Hughes
- Cancer Biology and Therapeutics Group, UCD Conway Institute, School of Biomolecular and Biomedical Science, University College Dublin, D04 V1W8 Dublin, Ireland.
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20
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Honda K, Katzke VA, Hüsing A, Okaya S, Shoji H, Onidani K, Olsen A, Tjønneland A, Overvad K, Weiderpass E, Vineis P, Muller D, Tsilidis K, Palli D, Pala V, Tumino R, Naccarati A, Panico S, Aleksandrova K, Boeing H, Bueno-de-Mesquita HB, Peeters PH, Trichopoulou A, Lagiou P, Khaw KT, Wareham N, Travis RC, Merino S, Duell EJ, Rodríguez-Barranco M, Chirlaque MD, Barricarte A, Rebours V, Boutron-Ruault MC, Romana Mancini F, Brennan P, Scelo G, Manjer J, Sund M, Öhlund D, Canzian F, Kaaks R. CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer: a prospective evaluation. Int J Cancer 2019; 144:1877-1887. [PMID: 30259989 PMCID: PMC6760974 DOI: 10.1002/ijc.31900] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/06/2018] [Accepted: 07/13/2018] [Indexed: 12/24/2022]
Abstract
Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform ("ApoA2-ATQ/AT"), alone and in combination with carbohydrate antigen 19-9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken ≤6 months before diagnosis, and 0.71 for >6-18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within >6-18 months (C = 0.74 vs. 0.71 for CA19-9 alone, p = 0.022) and ≤ 18 months (C = 0.75 vs. 0.74, p = 0.022). At 98% specificity, and for lag times of ≤6, >6-18 or ≤ 18 months, sensitivities were 57%, 36% and 43% for CA19-9 combined with ApoA2-ATQ/AT, respectively, vs. 50%, 29% and 36% for CA19-9 alone. Compared to CA19-9 alone, the combination of CA19-9 and ApoA2-ATQ/AT may improve detection of pancreatic cancer up to 18 months prior to diagnosis under usual care, and may provide a useful first measure for pancreatic cancer detection prior to imaging.
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Affiliation(s)
- Kazufumi Honda
- Department of Biomarker for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan
- Japan Agency for Medical Research and Development (AMED) CREST, Tokyo, Japan
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anika Hüsing
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Shinobu Okaya
- Department of Biomarker for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan
| | - Hirokazu Shoji
- Department of Biomarker for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kaoru Onidani
- Department of Biomarker for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan
| | - Anja Olsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
| | - David Muller
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M.P. Arezzo" Hospital, Ragusa, Italy
| | - Alessio Naccarati
- Department of Molecular and Genetic Epidemiology, IIGM - Italian Institute for Genomic Medicine, Torino, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - H Bas Bueno-de-Mesquita
- Department of Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Antonia Trichopoulou
- Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, School of Medicine, WHO Collaborating Center for Nutrition and Health
| | - Pagona Lagiou
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Kay-Tee Khaw
- Cancer Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Susana Merino
- Public Health Directorate, Asturias, Spain, Acknowledgment of funds: Regional Government of Asturias
| | - Eric J Duell
- PanC4 Consortium, Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel Rodríguez-Barranco
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - María Dolores Chirlaque
- Department of Epidemiology, Murcia Regional Health Council, CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Ronda de Levante, Murcia, Spain
| | - Aurelio Barricarte
- CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Vinciane Rebours
- Pancreatology Unit, Beaujon Hospital, Clichy, France
- INSERM - UMR 1149, University Paris 7, Paris, France
| | - Marie-Chiristine Boutron-Ruault
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
- Lifestyle, Genes and Health: Integrative Trans-Generational Epidemiology, Gustave Roussy, Villejuif, France
| | - Francesca Romana Mancini
- INSERM - UMR 1149, University Paris 7, Paris, France
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Ghislaine Scelo
- Section of Genetics, International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Jonas Manjer
- Department of Surgery, Skåne University Hospital, Lund University, Lund, Sweden
| | - Malin Sund
- Department of Surgical and Preoperative Sciences, Umeå University, Umeå, Sweden
| | - Daniel Öhlund
- Department of Radiation Sciences and Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Federico Canzian
- Genomic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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21
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Perrier F, Viallon V, Ambatipudi S, Ghantous A, Cuenin C, Hernandez-Vargas H, Chajès V, Baglietto L, Matejcic M, Moreno-Macias H, Kühn T, Boeing H, Karakatsani A, Kotanidou A, Trichopoulou A, Sieri S, Panico S, Fasanelli F, Dolle M, Onland-Moret C, Sluijs I, Weiderpass E, Quirós JR, Agudo A, Huerta JM, Ardanaz E, Dorronsoro M, Tong TYN, Tsilidis K, Riboli E, Gunter MJ, Herceg Z, Ferrari P, Romieu I. Association of leukocyte DNA methylation changes with dietary folate and alcohol intake in the EPIC study. Clin Epigenetics 2019; 11:57. [PMID: 30940212 PMCID: PMC6444439 DOI: 10.1186/s13148-019-0637-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background There is increasing evidence that folate, an important component of one-carbon metabolism, modulates the epigenome. Alcohol, which can disrupt folate absorption, is also known to affect the epigenome. We investigated the association of dietary folate and alcohol intake on leukocyte DNA methylation levels in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Leukocyte genome-wide DNA methylation profiles on approximately 450,000 CpG sites were acquired with Illumina HumanMethylation 450K BeadChip measured among 450 women control participants of a case-control study on breast cancer nested within the EPIC cohort. After data preprocessing using surrogate variable analysis to reduce systematic variation, associations of DNA methylation with dietary folate and alcohol intake, assessed with dietary questionnaires, were investigated using CpG site-specific linear models. Specific regions of the methylome were explored using differentially methylated region (DMR) analysis and fused lasso (FL) regressions. The DMR analysis combined results from the feature-specific analysis for a specific chromosome and using distances between features as weights whereas FL regression combined two penalties to encourage sparsity of single features and the difference between two consecutive features. Results After correction for multiple testing, intake of dietary folate was not associated with methylation level at any DNA methylation site, while weak associations were observed between alcohol intake and methylation level at CpG sites cg03199996 and cg07382687, with qval = 0.029 and qval = 0.048, respectively. Interestingly, the DMR analysis revealed a total of 24 and 90 regions associated with dietary folate and alcohol, respectively. For alcohol intake, 6 of the 15 most significant DMRs were identified through FL. Conclusions Alcohol intake was associated with methylation levels at two CpG sites. Evidence from DMR and FL analyses indicated that dietary folate and alcohol intake may be associated with genomic regions with tumor suppressor activity such as the GSDMD and HOXA5 genes. These results were in line with the hypothesis that epigenetic mechanisms play a role in the association between folate and alcohol, although further studies are warranted to clarify the importance of these mechanisms in cancer. Electronic supplementary material The online version of this article (10.1186/s13148-019-0637-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- F Perrier
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - V Viallon
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - S Ambatipudi
- Epigenetics Group, IARC, Lyon, France.,MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - C Cuenin
- Epigenetics Group, IARC, Lyon, France
| | | | - V Chajès
- Nutritional Epidemiology Group, IARC, Lyon, France
| | - L Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Matejcic
- Nutritional Epidemiology Group, IARC, Lyon, France.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | - T Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany
| | - A Karakatsani
- Hellenic Health Foundation, Athens, Greece.,2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | - A Kotanidou
- Hellenic Health Foundation, Athens, Greece.,1st Department of Critical Care Medicine and Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece
| | | | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - F Fasanelli
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Via Santena 7, Turin, Italy
| | - M Dolle
- National Institute of Public Health and the Environment (RIVM), Centre for Health Protection (pb12), Bilthoven, The Netherlands
| | - C Onland-Moret
- Department of Epidemiology, Julius Center Research Program Cardiovascular Epidemiology, Utrecht, The Netherlands
| | - I Sluijs
- Department of Epidemiology, Julius Center Research Program Cardiovascular Epidemiology, Utrecht, The Netherlands
| | - E Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Genetic Epidemiology Group, Folkhälsan Research Center and Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - J R Quirós
- Public Health Directorate, Asturias, Spain
| | - A Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J M Huerta
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.,CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - E Ardanaz
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.,CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain.,Navarra Public Health Institute, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M Dorronsoro
- Public Health Direction and Biodonostia Research Institute and CIBERESP, Basque Regional Health Department, San Sebastian, Spain
| | - T Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - M J Gunter
- Nutritional Epidemiology Group, IARC, Lyon, France
| | - Z Herceg
- Epigenetics Group, IARC, Lyon, France
| | - P Ferrari
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France.
| | - I Romieu
- Nutritional Epidemiology Group, IARC, Lyon, France
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22
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Murphy N, Achaintre D, Zamora‐Ros R, Jenab M, Boutron‐Ruault M, Carbonnel F, Savoye I, Kaaks R, Kühn T, Boeing H, Aleksandrova K, Tjønneland A, Kyrø C, Overvad K, Quirós JR, Sánchez M, Altzibar JM, María Huerta J, Barricarte A, Khaw K, Bradbury KE, Perez‐Cornago A, Trichopoulou A, Karakatsani A, Peppa E, Palli D, Grioni S, Tumino R, Sacerdote C, Panico S, Bueno‐de‐Mesquita HB, Peeters PH, Rutegård M, Johansson I, Freisling H, Noh H, Cross AJ, Vineis P, Tsilidis K, Gunter MJ, Scalbert A. A prospective evaluation of plasma polyphenol levels and colon cancer risk. Int J Cancer 2018; 143:1620-1631. [PMID: 29696648 PMCID: PMC6175205 DOI: 10.1002/ijc.31563] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/15/2018] [Accepted: 03/26/2018] [Indexed: 12/16/2022]
Abstract
Polyphenols have been shown to exert biological activity in experimental models of colon cancer; however, human data linking specific polyphenols to colon cancer is limited. We assessed the relationship between pre-diagnostic plasma polyphenols and colon cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition study. Using high pressure liquid chromatography coupled to tandem mass spectrometry, we measured concentrations of 35 polyphenols in plasma from 809 incident colon cancer cases and 809 matched controls. We used multivariable adjusted conditional logistic regression models that included established colon cancer risk factors. The false discovery rate (qvalues ) was computed to control for multiple comparisons. All statistical tests were two-sided. After false discovery rate correction and in continuous log2 -transformed multivariable models, equol (odds ratio [OR] per log2 -value, 0.86, 95% confidence interval [95% CI] = 0.79-0.93; qvalue = 0.01) and homovanillic acid (OR per log2 -value, 1.46, 95% CI = 1.16-1.84; qvalue = 0.02) were associated with colon cancer risk. Comparing extreme fifths, equol concentrations were inversely associated with colon cancer risk (OR = 0.61, 95% CI = 0.41-0.91, ptrend = 0.003), while homovanillic acid concentrations were positively associated with colon cancer development (OR = 1.72, 95% CI = 1.17-2.53, ptrend < 0.0001). No heterogeneity for these associations was observed by sex and across other colon cancer risk factors. The remaining polyphenols were not associated with colon cancer risk. Higher equol concentrations were associated with lower risk, and higher homovanillic acid concentrations were associated with greater risk of colon cancer. These findings support a potential role for specific polyphenols in colon tumorigenesis.
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Affiliation(s)
- Neil Murphy
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - David Achaintre
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - Raul Zamora‐Ros
- Unit of Nutrition and CancerCancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL)BarcelonaSpain
| | - Mazda Jenab
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | | | - Franck Carbonnel
- CESP, INSERM U1018, Univ. Paris‐Sud, UVSQ, Université Paris‐SaclayVillejuif CedexFrance
- Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP‐HPLe Kremlin BicêtreFrance
| | - Isabelle Savoye
- CESP, INSERM U1018, Univ. Paris‐Sud, UVSQ, Université Paris‐SaclayVillejuif CedexFrance
- Gustave Roussy, Espace Maurice TubianaVillejuif CedexFrance
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Tilman Kühn
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Heiner Boeing
- Department of EpidemiologyGerman Institute of Human NutritionPotsdam‐RehbrückeGermany
| | - Krasimira Aleksandrova
- Department of EpidemiologyNutrition, Immunity and Metabolism Start‐up LabPotsdam‐RehbrückeGermany
| | | | - Cecilie Kyrø
- Danish Cancer Society Research CenterCopenhagenDenmark
| | - Kim Overvad
- Department of Public HealthAarhus UniversityAarhusDenmark
| | | | - Maria‐Jose Sánchez
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de GranadaGranadaSpain
- CIBER de Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - Jone M. Altzibar
- CIBER de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Osakidetza/Basque Health ServiceBreast Cancer Screening ProgramBilbaoSpain
| | - José María Huerta
- CIBER de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Department of EpidemiologyMurcia Regional Health Council, IMIB‐ArrixacaMurciaSpain
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Navarra Public Health InstitutePamplonaSpain
- Navarra Institute for Health Research (IdiSNA)PamplonaSpain
| | - Kay‐Tee Khaw
- Department of Public Health and Primary Care, University of CambridgeCambridgeUnited Kingdom
| | - Kathryn E. Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Aurora Perez‐Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | | | - Anna Karakatsani
- Hellenic Health FoundationAthensGreece
- Pulmonary Medicine Department, School of MedicineNational and Kapodistrian University of Athens, “ATTIKON” University HospitalHaidariGreece
| | | | - Domenico Palli
- Cancer Risk Factors and Life‐Style Epidemiology UnitCancer Research and Prevention Institute—ISPOFlorenceItaly
| | - Sara Grioni
- Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Rosario Tumino
- Cancer Registry and Histopathology DepartmentCivic ‐ M.P. Arezzo” Hospital, ASP RagusaRagusaItaly
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University‐Hospital and Center for Cancer Prevention (CPO)TurinItaly
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e SperimentaleFederico II UniversityNaplesItaly
| | - H. B(as) Bueno‐de‐Mesquita
- Department for Determinants of Chronic Diseases (DCD)National Institute for Public Health and the Environment (RIVM), PO Box 1BilthovenBA3720The Netherlands
- Department of Gastroenterology and HepatologyUniversity Medical CentreUtrechtThe Netherlands
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUnited Kingdom
- Department of Social & Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Petra H. Peeters
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center UtrechtUtrechtThe Netherlands
- MRC‐PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUnited Kingdom
| | - Martin Rutegård
- Department of Surgical and Perioperative SciencesUmeå UniversityUmeåSweden
| | | | - Heinz Freisling
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - Hwayoung Noh
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - Amanda J. Cross
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUnited Kingdom
| | - Paolo Vineis
- MRC‐PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUnited Kingdom
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonUnited Kingdom
- Department of Hygiene and Epidemiology, School of MedicineUniversity of IoanninaIoanninaGreece
| | - Marc J. Gunter
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - Augustin Scalbert
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
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23
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Guida F, Sun N, Bantis LE, Muller DC, Li P, Taguchi A, Dhillon D, Kundnani DL, Patel NJ, Yan Q, Byrnes G, Moons KGM, Tjønneland A, Panico S, Agnoli C, Vineis P, Palli D, Bueno-de-Mesquita B, Peeters PH, Agudo A, Huerta JM, Dorronsoro M, Barranco MR, Ardanaz E, Travis RC, Byrne KS, Boeing H, Steffen A, Kaaks R, Hüsing A, Trichopoulou A, Lagiou P, La Vecchia C, Severi G, Boutron-Ruault MC, Sandanger TM, Weiderpass E, Nøst TH, Tsilidis K, Riboli E, Grankvist K, Johansson M, Goodman GE, Feng Z, Brennan P, Johansson M, Hanash SM. Assessment of Lung Cancer Risk on the Basis of a Biomarker Panel of Circulating Proteins. JAMA Oncol 2018; 4:e182078. [PMID: 30003238 PMCID: PMC6233784 DOI: 10.1001/jamaoncol.2018.2078] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/10/2018] [Indexed: 11/14/2022]
Abstract
Importance There is an urgent need to improve lung cancer risk assessment because current screening criteria miss a large proportion of cases. Objective To investigate whether a lung cancer risk prediction model based on a panel of selected circulating protein biomarkers can outperform a traditional risk prediction model and current US screening criteria. Design, Setting, and Participants Prediagnostic samples from 108 ever-smoking patients with lung cancer diagnosed within 1 year after blood collection and samples from 216 smoking-matched controls from the Carotene and Retinol Efficacy Trial (CARET) cohort were used to develop a biomarker risk score based on 4 proteins (cancer antigen 125 [CA125], carcinoembryonic antigen [CEA], cytokeratin-19 fragment [CYFRA 21-1], and the precursor form of surfactant protein B [Pro-SFTPB]). The biomarker score was subsequently validated blindly using absolute risk estimates among 63 ever-smoking patients with lung cancer diagnosed within 1 year after blood collection and 90 matched controls from 2 large European population-based cohorts, the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Northern Sweden Health and Disease Study (NSHDS). Main Outcomes and Measures Model validity in discriminating between future lung cancer cases and controls. Discrimination estimates were weighted to reflect the background populations of EPIC and NSHDS validation studies (area under the receiver-operating characteristics curve [AUC], sensitivity, and specificity). Results In the validation study of 63 ever-smoking patients with lung cancer and 90 matched controls (mean [SD] age, 57.7 [8.7] years; 68.6% men) from EPIC and NSHDS, an integrated risk prediction model that combined smoking exposure with the biomarker score yielded an AUC of 0.83 (95% CI, 0.76-0.90) compared with 0.73 (95% CI, 0.64-0.82) for a model based on smoking exposure alone (P = .003 for difference in AUC). At an overall specificity of 0.83, based on the US Preventive Services Task Force screening criteria, the sensitivity of the integrated risk prediction (biomarker) model was 0.63 compared with 0.43 for the smoking model. Conversely, at an overall sensitivity of 0.42, based on the US Preventive Services Task Force screening criteria, the integrated risk prediction model yielded a specificity of 0.95 compared with 0.86 for the smoking model. Conclusions and Relevance This study provided a proof of principle in showing that a panel of circulating protein biomarkers may improve lung cancer risk assessment and may be used to define eligibility for computed tomography screening.
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Affiliation(s)
- Florence Guida
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Nan Sun
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston
| | - Leonidas E Bantis
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
| | - David C Muller
- Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, United Kingdom
| | - Peng Li
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Ayumu Taguchi
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Dilsher Dhillon
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston
| | - Deepali L Kundnani
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston
| | - Nikul J Patel
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston
| | - Qingxiang Yan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
| | - Graham Byrnes
- Environment and Radiation Section, International Agency for Research on Cancer, Lyon, France
| | - Karel G M Moons
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, Netherlands
| | - Anne Tjønneland
- Unit of Diet, Genes, and Environment, Danish Cancer Society Research Center, Copenhagen
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, United Kingdom
- Molecular and Genetic Epidemiology Unit, Human Genetics Foundation, Torino, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute-Istituto per lo Studio e la Prevenzione Oncologica, Florence, Italy
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, United Kingdom
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, Netherlands
| | - Antonio Agudo
- Unit of Nutirition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jose M Huerta
- Department of Epidemiology, Murcia Regional Health Council, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Miren Dorronsoro
- Public Health Direction and Biodonostia Research Institute-CIBERESP, San Sebastian, Spain
| | - Miguel Rodriguez Barranco
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria, Granada, Spain
- Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Epidemiology, Prevention, and Promotion Health Service, Navarra Public Health Institute, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra Institute for Health Research, Pamplona, Spain
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Karl Smith Byrne
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke
| | - Annika Steffen
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke
| | - Rudolf Kaaks
- Divison of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg
| | - Anika Hüsing
- Divison of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- World Health Organization Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Pagona Lagiou
- Hellenic Health Foundation, Athens, Greece
- World Health Organization Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Gianluca Severi
- Molecular and Genetic Epidemiology Unit, Human Genetics Foundation, Torino, Italy
- Université Paris-Saclay, Université Paris-Sud, Université de Versailles Saint-Quentin-en-Yvelines, Centre de Recherche en Epidémiologie et Santé des Populations, National Institute for Health and Medical Research (INSERM), Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Université Paris-Saclay, Université Paris-Sud, Université de Versailles Saint-Quentin-en-Yvelines, Centre de Recherche en Epidémiologie et Santé des Populations, National Institute for Health and Medical Research (INSERM), Villejuif, France
| | - Torkjel M Sandanger
- Department of Community Medicine, Universtiy of Tromsø, Arctic University of Norway, Tromsø
| | - Elisabete Weiderpass
- Department of Community Medicine, Universtiy of Tromsø, Arctic University of Norway, Tromsø
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Therese H Nøst
- Department of Community Medicine, Universtiy of Tromsø, Arctic University of Norway, Tromsø
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, United Kingdom
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, United Kingdom
| | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Mikael Johansson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Gary E Goodman
- Public Health Sciences Division, Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ziding Feng
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Mattias Johansson
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Samir M Hanash
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston
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24
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Butt J, Jenab M, Willhauck-Fleckenstein M, Michel A, Pawlita M, Kyrø C, Tjønneland A, Boutron-Ruault MC, Carbonnel F, Severi G, Kaaks R, Kühn T, Boeing H, Trichopoulou A, la Vecchia C, Karakatsani A, Panico S, Tumino R, Agnoli C, Palli D, Sacerdote C, Bueno-de-Mesquita HBA, Weiderpass E, Sánchez MJ, Bonet Bonet C, Huerta JM, Ardanaz E, Bradbury K, Gunter M, Murphy N, Freisling H, Riboli E, Tsilidis K, Aune D, Waterboer T, Hughes DJ. Prospective evaluation of antibody response to Streptococcus gallolyticus and risk of colorectal cancer. Int J Cancer 2018; 143:245-252. [PMID: 29377173 DOI: 10.1002/ijc.31283] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/20/2017] [Accepted: 01/05/2018] [Indexed: 02/06/2023]
Abstract
The gut microbiome is increasingly implicated in colorectal cancer (CRC) development. A subgroup of patients diagnosed with CRC show high antibody responses to Streptococcus gallolyticus subspecies gallolyticus (SGG). However, it is unclear whether the association is also present pre-diagnostically. We assessed the association of antibody responses to SGG proteins in pre-diagnostic serum samples with CRC risk in a case-control study nested within a prospective cohort. Pre-diagnostic serum samples from 485 first incident CRC cases (mean time between blood draw and diagnosis 3.4 years) and 485 matched controls in the European Prospective Investigation into Nutrition and Cancer (EPIC) study were analyzed for antibody responses to 11 SGG proteins using multiplex serology. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable conditional logistic regression models. Antibody positivity for any of the 11 SGG proteins was significantly associated with CRC risk with 56% positive controls compared to 63% positive cases (OR: 1.36, 95% CI: 1.04-1.77). Positivity for two or more proteins of a previously identified SGG 6-marker panel with greater CRC-specificity was also observed among 9% of controls compared to 17% of CRC cases, corresponding to a significantly increased CRC risk (OR: 2.17, 95% CI: 1.44-3.27). In this prospective nested case-control study, we observed a positive association between antibody responses to SGG and CRC development in serum samples taken before evident disease onset. Further work is required to establish the possibly etiological significance of these observations and whether SGG serology may be applicable for CRC risk stratification.
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Affiliation(s)
- Julia Butt
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mazda Jenab
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | | | - Angelika Michel
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cecilie Kyrø
- Diet, Genes and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Diet, Genes and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Marie-Christine Boutron-Ruault
- CESP, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, Cedex, France
- INSERM UMR 2018 - Health across Generations Team, Institute Gustave Roussy, Villejuif, France
| | - Franck Carbonnel
- CESP, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, Cedex, France
- INSERM UMR 2018 - Health across Generations Team, Institute Gustave Roussy, Villejuif, France
- Université Paris Sud and Gastroenterology Unit, Hopitaux Universitaires Paris Sud, CHU de Bicetre, AP-HP, Le Kremlin Bicetre, France
| | - Gianluca Severi
- CESP, INSERM U1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, Cedex, France
- INSERM UMR 2018 - Health across Generations Team, Institute Gustave Roussy, Villejuif, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Carlo la Vecchia
- Hellenic Health Foundation, Athens, Greece
- Department of Clinical Sciences and Community Health, Universita degli Studi dei Milano, Italy
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | - Salvatore Panico
- Dipartamento di Medicina Clinica e Chirugia, Federico II University, Naples, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, 'Civic-M.P. Arezzo' Hospital, Ragusa, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - H B As Bueno-de-Mesquita
- Department of Determinants of Chronic Diseases (DCD), National Institute for Public Health and Environment (RIVM), Bilthoven, Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institut, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Maria-José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigacion Biosanitaria ibs, Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Catalina Bonet Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia, Llobregat, Spain
| | - José María Huerta
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Kathryn Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Marc Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Heinz Freisling
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina school of Medicine, Ioannina, Greece
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Tim Waterboer
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David J Hughes
- Cancer Biology and Therapeutics Group, UCD Conway Institute, University College Dublin, Dublin, Ireland
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25
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Agudo A, Cayssials V, Bonet C, Tjønneland A, Overvad K, Boutron-Ruault MC, Affret A, Fagherazzi G, Katzke V, Schübel R, Trichopoulou A, Karakatsani A, La Vecchia C, Palli D, Grioni S, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita B, Peeters PH, Weiderpass E, Skeie G, Nøst TH, Lasheras C, Rodríguez-Barranco M, Amiano P, Chirlaque MD, Ardanaz E, Ohlsson B, Dias JA, Nilsson LM, Myte R, Khaw KT, Perez-Cornago A, Gunter M, Huybrechts I, Cross AJ, Tsilidis K, Riboli E, Jakszyn P. Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr 2018; 107:607-616. [PMID: 29635497 DOI: 10.1093/ajcn/nqy002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/26/2017] [Indexed: 12/13/2022] Open
Abstract
Background Chronic inflammation plays a critical role in the pathogenesis of the 2 major types of gastric cancer. Several foods, nutrients, and nonnutrient food components seem to be involved in the regulation of chronic inflammation. Objective We assessed the association between the inflammatory potential of the diet and the risk of gastric carcinoma, overall and for the 2 major subsites: cardia cancers and noncardia cancers. Design A total of 476,160 subjects (30% men, 70% women) from the European Investigation into Cancer and Nutrition (EPIC) study were followed for 14 y, during which 913 incident cases of gastric carcinoma were identified, including 236 located in the cardia, 341 in the distal part of the stomach (noncardia), and 336 with overlapping or unknown tumor site. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated with the use of 28 dietary components and their corresponding inflammatory scores. The association between the ISD and gastric cancer risk was estimated by HRs and 95% CIs calculated by multivariate Cox regression models adjusted for confounders. Results The inflammatory potential of the diet was associated with an increased risk of gastric cancer. The HR (95% CI) for each increase in 1 SD of the ISD were 1.25 (1.12, 1.39) for all gastric cancers, 1.30 (1.06, 1.59) for cardia cancers, and 1.07 (0.89, 1.28) for noncardia cancers. The corresponding values for the highest compared with the lowest quartiles of the ISD were 1.66 (1.26, 2.20), 1.94 (1.14, 3.30), and 1.07 (0.70, 1.70), respectively. Conclusions Our results suggest that low-grade chronic inflammation induced by the diet may be associated with gastric cancer risk. This pattern seems to be more consistent for gastric carcinomas located in the cardia than for those located in the distal stomach. This study is listed on the ISRCTN registry as ISRCTN12136108.
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Affiliation(s)
- Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Valerie Cayssials
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Aurélie Affret
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Guy Fagherazzi
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic-M.P.Arezzo" Hospital, Ragusa, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Salvatore Panico
- Dipartamento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, United Kingdom
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Theresa H Nøst
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Cristina Lasheras
- Departamento de Biología Funcional, Facultad de Medicina, Universidad de Oviedo, Asturias, Spain
| | - Miguel Rodríguez-Barranco
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Pilar Amiano
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain
- BioDonostia Research Institute, San Sebastian, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Navarra Public Health Institute, IdiSNA (Navarra Institute for Health Research), Pamplona, Spain
| | - Bodil Ohlsson
- Lund University, Skane University Hospital, Division of Internal Medicine, Malmö, Sweden
| | - Joana A Dias
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University. Malmö, Sweden
| | - Lena M Nilsson
- Public Health and Clinical Medicine, Nutritional Research and
| | - Robin Myte
- Public Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- University of Cambridge, Cambridge, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Marc Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Amanda J Cross
- School of Public Health, Imperial College London, United Kingdom
| | - Kostas Tsilidis
- School of Public Health, Imperial College London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elio Riboli
- School of Public Health, Imperial College London, United Kingdom
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Facultat Ciències Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
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26
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Barrdahl M, Canzian F, Gaudet MM, Gapstur SM, Trichopoulou A, Tsilidis K, van Gils CH, Borgquist S, Weiderpass E, Khaw KT, Giles GG, Milne RL, Le Marchand L, Haiman C, Lindström S, Kraft P, Hunter DJ, Ziegler R, Chanock SJ, Yang XR, Buring JE, Lee IM, Kaaks R, Campa D. A comprehensive analysis of polymorphic variants in steroid hormone and insulin-like growth factor-1 metabolism and risk of in situ breast cancer: Results from the Breast and Prostate Cancer Cohort Consortium. Int J Cancer 2018; 142:1182-1188. [PMID: 29114882 DOI: 10.1002/ijc.31145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/26/2017] [Accepted: 08/04/2017] [Indexed: 11/08/2022]
Abstract
We assessed the association between 1,414 single nucleotide polymorphisms (SNPs) in genes involved in synthesis and metabolism of steroid hormones and insulin-like growth factor 1, and risk of breast cancer in situ (BCIS), with the aim of determining whether any of these were disease specific. This was carried out using 1,062 BCIS cases and 10,126 controls as well as 6,113 invasive breast cancer cases from the Breast and Prostate Cancer Cohort Consortium (BPC3). Three SNPs showed at least one nominally significant association in homozygous minor versus homozygous major models. ACVR2A-rs2382112 (ORhom = 3.05, 95%CI = 1.72-5.44, Phom = 1.47 × 10-4 ), MAST2-rs12124649 (ORhom = 1.73, 95% CI =1.18-2.54, Phom = 5.24 × 10-3 ), and INSR-rs10500204 (ORhom = 1.96, 95% CI = 1.44-2.67, Phom =1.68 × 10-5 ) were associated with increased risk of BCIS; however, only the latter association was significant after correcting for multiple testing. Furthermore, INSR-rs10500204 was more strongly associated with the risk of BCIS than invasive disease in case-only analyses using the homozygous minor versus homozygous major model (ORhom = 1.78, 95% CI = 1.30-2.44, Phom = 3.23 × 10-4 ). The SNP INSR-rs10500204 is located in an intron of the INSR gene and is likely to affect binding of the promyelocytic leukemia (PML) protein. The PML gene is known as a tumor suppressor and growth regulator in cancer. However, it is not clear on what pathway the A-allele of rs10500204 could operate to influence the binding of the protein. Hence, functional studies are warranted to investigate this further.
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Affiliation(s)
- Myrto Barrdahl
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | | | - Kostas Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Carla H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Signe Borgquist
- Clinical Trial Unit, Skåne University Hospital, Lund, Sweden.,Division of Oncology and Pathology, Clinical Sciences, Lund, Lund University, Sweden
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, VIC, Australia.,Faculty of Medicine, Monash University, Melbourne, VIC, Australia
| | - Roger L Milne
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Loic Le Marchand
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI
| | - Christopher Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Sara Lindström
- Department of Epidemiology, University of Washington; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA
| | - David J Hunter
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA
| | - Regina Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Pike Bethesda, MD
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Pike Bethesda, MD.,Core Genotyping Facility, Frederick National Laboratory for Cancer Research, Gaithersburg, MD
| | - Xiaohong R Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Pike Bethesda, MD
| | - Julie E Buring
- Divisions of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - I-Min Lee
- Divisions of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniele Campa
- Department of Biology, University of Pisa, Pisa, Italy
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27
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Huang J, Zagai U, Hallmans G, Nyrén O, Engstrand L, Stolzenberg-Solomon R, Duell EJ, Overvad K, Katzke VA, Kaaks R, Jenab M, Park JY, Murillo R, Trichopoulou A, Lagiou P, Bamia C, Bradbury KE, Riboli E, Aune D, Tsilidis K, Capellá G, Agudo A, Krogh V, Palli D, Panico S, Vainio EW, Tjønneland A, Olsen A, Martínez B, Redondo-Sanchez D, Chirlaque MD, Peeters PH, Regnér S, Lindkvist B, Naccarati A, Miren DI, Larrañaga N, Boutron-Ruault MC, Rebours V, Barré A, Redondo-Sanchez D, Bueno-de-Mesquita H, Ye W. Helicobacter pylori infection, chronic corpus atrophic gastritis and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: A nested case-control study. Int J Cancer 2017; 140:1727-1735. [PMID: 28032715 PMCID: PMC5930360 DOI: 10.1002/ijc.30590] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/22/2016] [Indexed: 12/11/2022]
Abstract
The association between H. pylori infection and pancreatic cancer risk remains controversial. We conducted a nested case-control study with 448 pancreatic cancer cases and their individually matched control subjects, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, to determine whether there was an altered pancreatic cancer risk associated with H. pylori infection and chronic corpus atrophic gastritis. Conditional logistic regression models were applied to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for matching factors and other potential confounders. Our results showed that pancreatic cancer risk was neither associated with H. pylori seropositivity (OR = 0.96; 95% CI: 0.70, 1.31) nor CagA seropositivity (OR = 1.07; 95% CI: 0.77, 1.48). We also did not find any excess risk among individuals seropositive for H. pylori but seronegative for CagA, compared with the group seronegative for both antibodies (OR = 0.94; 95% CI: 0.63, 1.38). However, we found that chronic corpus atrophic gastritis was non-significantly associated with an increased pancreatic cancer risk (OR = 1.35; 95% CI: 0.77, 2.37), and although based on small numbers, the excess risk was particularly marked among individuals seronegative for both H. pylori and CagA (OR = 5.66; 95% CI: 1.59, 20.19, p value for interaction < 0.01). Our findings provided evidence supporting the null association between H. pylori infection and pancreatic cancer risk in western European populations. However, the suggested association between chronic corpus atrophic gastritis and pancreatic cancer risk warrants independent verification in future studies, and, if confirmed, further studies on the underlying mechanisms.
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Affiliation(s)
- Jiaqi Huang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Ulrika Zagai
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Nutrition, Umeå University, Umeå, Sweden
| | - Olof Nyrén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Lars Engstrand
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Rachael Stolzenberg-Solomon
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, USA
| | - Eric J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mazda Jenab
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Jin Young Park
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Raul Murillo
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Greece
| | - Pagona Lagiou
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, USA
| | - Christina Bamia
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Greece
| | - Kathryn E Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Gabriel Capellá
- Translational Research Laboratory, IDIBELL-Catalan Institute of Oncology, Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. L’Hospitalet de Llobregat, Barcelona, Spain
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, Milano, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy
| | - Salvatore Panico
- Dipartimento di medicina clinica e chirurgia Federico II, Naples, Italy
| | - Elisabete Weiderpass Vainio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research. Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | | | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Begoña Martínez
- Andalusian School of Public Health, Instituto De Investigación Biosanitaria Ibs, GRANADA, Spain
| | - Daniel Redondo-Sanchez
- Andalusian School of Public Health, Instituto De Investigación Biosanitaria Ibs, GRANADA, Spain
| | - Maria-Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Petra H. Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Sara Regnér
- Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Björn Lindkvist
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alessio Naccarati
- Molecular and Genetic Epidemiology Unit, Human Genetics Foundation, Turin, Italy
| | - Dorronsoro-Iraeta Miren
- Department of Health of the Basque Government, Public Health Division of Gipuzkoa, San Sebastian, Spain
| | - Nerea Larrañaga
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
- Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Spain
| | - MC Boutron-Ruault
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805, Villejuif, France
- Université Paris Sud, UMRS 1018, F-94805, Villejuif, France
- Institut Gustave Roussy, F-94805, Villejuif, France
| | - Vinciane Rebours
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, University Paris 7, Clichy, France
| | - Amélie Barré
- Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | - Daniel Redondo-Sanchez
- CIBER of Epidemiology and Public Health (CIBERESP), Spain
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs, GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - H.B(as) Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
- The Medical Biobank at Umeå University, Umeå, Sweden
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28
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Murphy N, Cross AJ, Abubakar M, Jenab M, Aleksandrova K, Boutron-Ruault MC, Dossus L, Racine A, Kühn T, Katzke VA, Tjønneland A, Petersen KEN, Overvad K, Quirós JR, Jakszyn P, Molina-Montes E, Dorronsoro M, Huerta JM, Barricarte A, Khaw KT, Wareham N, Travis RC, Trichopoulou A, Lagiou P, Trichopoulos D, Masala G, Krogh V, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Siersema PD, Peeters PH, Ohlsson B, Ericson U, Palmqvist R, Nyström H, Weiderpass E, Skeie G, Freisling H, Kong SY, Tsilidis K, Muller DC, Riboli E, Gunter MJ. A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). PLoS Med 2016; 13:e1001988. [PMID: 27046222 PMCID: PMC4821615 DOI: 10.1371/journal.pmed.1001988] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 02/23/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. METHODS AND FINDINGS The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI ≥ 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI ≥ 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [≥80 cm for women and ≥94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of <0.05 was considered statistically significant. In multivariable-adjusted conditional logistic regression models with BMI used to define adiposity, compared with metabolically healthy/normal weight individuals, we observed a higher colorectal cancer risk among metabolically unhealthy/normal weight (odds ratio [OR] = 1.59, 95% CI 1.10-2.28) and metabolically unhealthy/overweight (OR = 1.40, 95% CI 1.01-1.94) participants, but not among metabolically healthy/overweight individuals (OR = 0.96, 95% CI 0.65-1.42). Among the overweight individuals, lower colorectal cancer risk was observed for metabolically healthy/overweight individuals compared with metabolically unhealthy/overweight individuals (OR = 0.69, 95% CI 0.49-0.96). These associations were generally consistent when waist circumference was used as the measure of adiposity. To our knowledge, there is no universally accepted clinical definition for using C-peptide level as an indication of hyperinsulinaemia. Therefore, a possible limitation of our analysis was that the classification of individuals as being hyperinsulinaemic-based on their C-peptide level-was arbitrary. However, when we used quartiles or the median of C-peptide, instead of tertiles, as the cut-point of hyperinsulinaemia, a similar pattern of associations was observed. CONCLUSIONS These results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia. The combination of anthropometric measures with metabolic parameters, such as C-peptide, may be useful for defining strata of the population at greater risk of colorectal cancer.
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Affiliation(s)
- Neil Murphy
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Amanda J. Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Mustapha Abubakar
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Mazda Jenab
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany
| | - Marie-Christine Boutron-Ruault
- Inserm, Nutrition, Hormones and Women’s Health, Centre for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
- Université Paris Sud, UMRS 1018, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Laure Dossus
- Inserm, Nutrition, Hormones and Women’s Health, Centre for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
- Université Paris Sud, UMRS 1018, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Antoine Racine
- Inserm, Nutrition, Hormones and Women’s Health, Centre for Research in Epidemiology and Population Health (CESP), U1018, Villejuif, France
- Université Paris Sud, UMRS 1018, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena A. Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Paula Jakszyn
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain
| | - Esther Molina-Montes
- Andalusian School of Public Health, Granada, Spain
- Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miren Dorronsoro
- Public Health Direction and Biodonostia–CIBERESP, Basque Regional Health Department, Vitoria, Spain
| | - José-María Huerta
- Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
| | - Aurelio Barricarte
- Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarre Public Health Institute, Pamplona, Spain
| | - Kay-Tee Khaw
- University of Cambridge, Cambridge, United Kingdom
| | - Nick Wareham
- MRC Epidemiology Unit, Cambridge, United Kingdom
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Dimitrios Trichopoulos
- Hellenic Health Foundation, Athens, Greece
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, Civic–M.P.Arezzo Hospital, Azienda Sanitaria Provinciale di Ragusa, Italy
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- HuGeF Foundation, Torino, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Sperimentale, Federico II University, Naples, Italy
| | - H. Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Determinants of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Peter D. Siersema
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Petra H. Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bodil Ohlsson
- Division of Internal Medicine, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ulrika Ericson
- Diabetes and Cardiovascular Disease–Genetic Epidemiology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Lund University, Sweden
| | | | | | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway, Tromsø, Norway
- Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway, Tromsø, Norway
| | - Heinz Freisling
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - So Yeon Kong
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - David C. Muller
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Aleksandrova K, Bamia C, Drogan D, Lagiou P, Trichopoulou A, Jenab M, Fedirko V, Romieu I, Bueno-de-Mesquita HB, Pischon T, Tsilidis K, Overvad K, Tjønneland A, Bouton-Ruault MC, Dossus L, Racine A, Kaaks R, Kühn T, Tsironis C, Papatesta EM, Saitakis G, Palli D, Panico S, Grioni S, Tumino R, Vineis P, Peeters PH, Weiderpass E, Lukic M, Braaten T, Quirós JR, Luján-Barroso L, Sánchez MJ, Chilarque MD, Ardanas E, Dorronsoro M, Nilsson LM, Sund M, Wallström P, Ohlsson B, Bradbury KE, Khaw KT, Wareham N, Stepien M, Duarte-Salles T, Assi N, Murphy N, Gunter MJ, Riboli E, Boeing H, Trichopoulos D. The association of coffee intake with liver cancer risk is mediated by biomarkers of inflammation and hepatocellular injury: data from the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr 2015; 102:1498-508. [PMID: 26561631 PMCID: PMC4658462 DOI: 10.3945/ajcn.115.116095] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/22/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Higher coffee intake has been purportedly related to a lower risk of liver cancer. However, it remains unclear whether this association may be accounted for by specific biological mechanisms. OBJECTIVE We aimed to evaluate the potential mediating roles of inflammatory, metabolic, liver injury, and iron metabolism biomarkers on the association between coffee intake and the primary form of liver cancer-hepatocellular carcinoma (HCC). DESIGN We conducted a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition among 125 incident HCC cases matched to 250 controls using an incidence-density sampling procedure. The association of coffee intake with HCC risk was evaluated by using multivariable-adjusted conditional logistic regression that accounted for smoking, alcohol consumption, hepatitis infection, and other established liver cancer risk factors. The mediating effects of 21 biomarkers were evaluated on the basis of percentage changes and associated 95% CIs in the estimated regression coefficients of models with and without adjustment for biomarkers individually and in combination. RESULTS The multivariable-adjusted RR of having ≥4 cups (600 mL) coffee/d compared with <2 cups (300 mL)/d was 0.25 (95% CI: 0.11, 0.62; P-trend = 0.006). A statistically significant attenuation of the association between coffee intake and HCC risk and thereby suspected mediation was confirmed for the inflammatory biomarker IL-6 and for the biomarkers of hepatocellular injury glutamate dehydrogenase, alanine aminotransferase, aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), and total bilirubin, which-in combination-attenuated the regression coefficients by 72% (95% CI: 7%, 239%). Of the investigated biomarkers, IL-6, AST, and GGT produced the highest change in the regression coefficients: 40%, 56%, and 60%, respectively. CONCLUSION These data suggest that the inverse association of coffee intake with HCC risk was partly accounted for by biomarkers of inflammation and hepatocellular injury.
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Affiliation(s)
- Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany;
| | - Christina Bamia
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Dagmar Drogan
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Pagona Lagiou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | - Antonia Trichopoulou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Mazda Jenab
- International Agency for Research on Cancer, Lyon, France
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; Winship Cancer Institute, Emory University, Atlanta, GA
| | | | - H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands; Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tobias Pischon
- Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine, Berlin-Buch, Germany
| | - Kostas Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, Ioannina, Greece
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Marie-Christine Bouton-Ruault
- Inserm, Centre for Research in Epidemiology and Population Health, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris Sud, Villejuif, France; IGR, Villejuif, France
| | - Laure Dossus
- Inserm, Centre for Research in Epidemiology and Population Health, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris Sud, Villejuif, France; IGR, Villejuif, France
| | - Antoine Racine
- Inserm, Centre for Research in Epidemiology and Population Health, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris Sud, Villejuif, France; IGR, Villejuif, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | | | | | | | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - Salvatore Panico
- Department of Clinical and Experimental Medicine-Federico II University, Naples, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "M.P. Arezzo" Hospital, Ragusa, Italy
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; HuGeF Foundation, Turin, Italy
| | - Petra H Peeters
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, Netherlands
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Marko Lukic
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Tonje Braaten
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | | | - Leila Luján-Barroso
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - María-José Sánchez
- CIBER de Epidemiología y Salud Pública, Spain; Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Maria-Dolores Chilarque
- CIBER de Epidemiología y Salud Pública, Spain; Department of Epidemiology, Murcia Regional Health Authority, IMIB-Arrixaca, Murcia, Spain
| | - Eva Ardanas
- CIBER de Epidemiología y Salud Pública, Spain; Navarre Public Health Institute, Pamplona, Spain
| | - Miren Dorronsoro
- Epidemiology and Health Information, Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain
| | | | - Malin Sund
- Department of Surgical and Perioperative Sciences, Surgery and Public Health, Nutrition Research, Umeå University, Umeå, Sweden
| | - Peter Wallström
- Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden
| | - Bodil Ohlsson
- Department of Clinical Science, Division of Internal Medicine, Skane University Hospital, Malmö, Lund University, Malmö, Sweden
| | - Kathryn E Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; and
| | - Nick Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | | | | | - Nada Assi
- International Agency for Research on Cancer, Lyon, France
| | - Neil Murphy
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Dimitrios Trichopoulos
- Hellenic Health Foundation, Athens, Greece; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
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30
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Campa D, McKay J, Sinilnikova O, Hüsing A, Vogel U, Hansen RD, Overvad K, Witt PM, Clavel-Chapelon F, Boutron-Ruault MC, Chajes V, Rohrmann S, Chang-Claude J, Boeing H, Fisher E, Trichopoulou A, Trichopoulos D, Palli D, Villarini A, Sacerdote C, Mattiello A, Tumino R, Peeters PHM, van Gils CH, Bas Bueno-de-Mesquita H, Lund E, Chirlaque MD, Sala N, Suarez LR, Barricarte A, Dorronsoro M, Sánchez MJ, Lenner P, Hallmans G, Tsilidis K, Bingham S, Khaw KT, Gallo V, Norat T, Riboli E, Rinaldi S, Lenoir G, Tavtigian SV, Canzian F, Kaaks R. Genetic variation in genes of the fatty acid synthesis pathway and breast cancer risk. Breast Cancer Res Treat 2009; 118:565-74. [PMID: 19252981 DOI: 10.1007/s10549-009-0347-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 02/11/2009] [Indexed: 10/21/2022]
Abstract
Fatty acid synthase (FAS) is the major enzyme of lipogenesis. It catalyzes the NADPH-dependent condensation of acetyl-CoA and malonyl-CoA to produce palmitic acid. Transcription of the FAS gene is controlled synergistically by the transcription factors ChREBP (carbohydrate response element-binding protein), which is induced by glucose, and SREBP-1 (sterol response element-binding protein-1), which is stimulated by insulin through the PI3K/Akt signal transduction pathway. We investigated whether the genetic variability of the genes encoding for ChREBP, SREBP and FAS (respectively, MLXIPL, SREBF1 and FASN) is related to breast cancer risk and body-mass index (BMI) by studying 1,294 breast cancer cases and 2,452 controls from the European Prospective Investigation on Cancer (EPIC). We resequenced the FAS gene and combined information of SNPs found by resequencing and SNPs from public databases. Using a tagging approach and selecting 20 SNPs, we covered all the common genetic variation of these genes. In this study we were not able to find any statistically significant association between the SNPs in the FAS, ChREBP and SREPB-1 genes and an increased risk of breast cancer overall and by subgroups of age, menopausal status, hormone replacement therapy (HRT) use or BMI. On the other hand, we found that two SNPs in FASN were associated with BMI.
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Affiliation(s)
- Daniele Campa
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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